Electronic health records (EHRs) have developed an essential but neglected part of our healthcare system. According to HealthIT.gov, electronic health records are digital versions of outmoded patient charts and records that contain a patient’s medical history and treatment. Many people also think of an EHR as an online portal that healthcare providers and patients use to track and manage care, tests, and medications.
EHR information is easily accessible to healthcare providers and becomes integral to the patient’s medical history. These records also deliver access to tools used to improve decision-making. Effective EHRs automate and streamline healthcare providers and the workflows needed to provide care.
While EHR systems in healthcare organization software often appear all-in-one and intuitive, implementing a new system is monumental. Here’s a look at the EHR system application, the top challenges healthcare providers face during the change, and the steps to take for a smooth transition.
Why EHR Implementation is So Difficult
According to Leidos Health’s EHR deployment guidelines—also called go-live activities—implementing an EHR system is multifaceted. These activities are the culmination of a significant investment of time, effort, and money, and their success is measured by staff adoption, financial impact, and patient value.
According to Leidos’ Best Practices for EHR Implementation, successful EHR implementation requires planning, testing, training, and piloting systems before deploying them. Before work begins, the healthcare provider must prepare for all implementation aspects, including providing staff with the necessary time and resources to become familiar with the new procedures, applications, and expectations.
There are also technical hurdles: IT staff must carefully review all EHR builds to ensure they are complete. This includes checking the compatibility of all hardware, software, and network interfaces, primarily if a telemedicine element exists. There should also be procedures for backup and downtime, and staff will need access credentials.
With so many complexities and variables contributing to successful EHR implementation, hospitals must define expected outcomes and mitigate the following critical issues.
Task 1: Budgeting and finding the right partner
Electronic health records are expensive and labor-intensive—two characteristics we cannot overemphasize. Here are some tips for budgeting correctly and finding the right supplier partner:
- Plan well and be generous. Because of the uncertainty inherent in EHR deployment, hospitals should consider creating a large EHR implementation budget to allow additional or emergency resources. As Leidos management advises, unused funds can always be returned; the real challenge is getting more funding while the system is being deployed. When budgeting, the company you partner with to provide startup support should help you estimate the project’s total cost.
- Remember that you get what you pay for. Along with the need for flexible budgets, hospital managers must understand that, as with many aspects of life and business, you often get what you pay for, and the cheapest contractor is not always the right choice. Leidos notes that the company that offers the lowest estimate will likely face cost overruns due to staffing and hiring shortages, which could jeopardize the launch date.
- Select a supplier. Planning is essential when choosing a vendor to help you with your EHR implementation, Leidos says. Management recommends researching the potential supplier to ensure the company is up to the job. It would help if you also tried to negotiate with your partner as soon as possible to increase the chances of a successful implementation. Leidos advises hospitals to provide potential contractors with a detailed schedule and list of needs to ensure accurate proposals.
Problem 2: Failure in communication and training
Healthcare providers implementing EHRs should prioritize communication training and critical planning. Here are some tips for smoother communication and successful learning:
- Define all variables. Effective communication and training begin with identifying all the variables involved in EHR implementation. For example, you must determine whether the EHR you choose prohibits physicians from working until training is completed.
- Walk around supplier staff. Including provider implementation staff in any training programs is essential to ensure they understand provider processes and workflows. Training should be provided as early as possible to ensure staff are ready to begin work by the launch date.
- Select the right players. Leidos emphasized the importance of “mixing the right players.” This includes ensuring all users complete training and making contingency plans for those who must complete post-launch training. The launch support team will play a significant role: Leidos says employees will have to use the system several times under the guidance of the launch support team before they feel comfortable with the new system.
- Appoint a project manager. Hospitals should appoint a project manager who will communicate with all stakeholders. This person will be the liaison between senior management and tactical project managers. The designated project manager will ensure coordination between stakeholders to ensure the hospital, suppliers, and contractors have the right people in place and the right level of support for clinical, operational, and administrative functions.
- Speak openly. Communication is also vital to meet all supplies for new support staff. Communication facilitates the development of time frames, which avoids unnecessary delays in implementation.
Objective 3: Contingency planning and management support
Something will go wrong if there’s one certainty about running an EHR. During a launch, you will inevitably have to escalate requests for help beyond what you have planned for the launch team. Here are some tips to avoid unexpected crises:
- Empower your startup workforce. Electronic Health providers must provide startup personnel with the ability to deal with unforeseen problems. A clearly defined escalation plan is essential to respond to emergencies and minimize staff and patient frustration quickly.
- Plan to resolve problems. Leidos advises startup support teams to develop specific procedures to identify and resolve technical issues, including hardware and software problems. Assigning someone responsible for each type of issue and sharing fixes for known issues is essential. As problems are discovered, addressed, and resolved, everyone must know about the new system.
- Provide leadership support. Another critical factor in emergency management is management support. Introducing an EHR brings an element of change to the current environment. Because change is difficult, leaders must understand that the EHR implementation will be successful once patients and providers accept the new system. It is ideal for managers to understand and communicate the benefits of new systems so that users know that support staff are available to help if any problems arise. It is also essential that users know how to access support quickly.
Task 4: Workflows
Workflows are essential elements that Electronic Health providers should focus on when planning, documenting, and reporting their EHR implementation. However, not all healthcare workflows are created equally; some are more sensitive and important to patient well-being.
Here are some of the more compound and challenging workflows to remember.
- Blood banks. Blood banks depend on lives, so EHR implementation must ensure this workflow is fully accounted for.
- Reconciliation of medications. Before EHR implementations go live, healthcare facilities must ensure the system can track medicines before and after admission.
- Patient movement. Monitoring patients’ movements during their hospital stay is critical to providing appropriate care.
- Level of medical care. Properly documenting the stages of a patient’s illness—whether in the emergency room or the intensive care unit—is essential for medical and administrative reasons and can even impact medical billing accuracy.
- Careful transportation. The way patients are transported throughout the facility must be carefully controlled.
