Electronic Health Record (EHR) -Strategic Planning and Implementation

One of the areas most overlooked in acquiring a EHR is how that technology will impact the culture and work processes in that organization.  Usually there is a more fiscal and state of the art discussion with the senior team to decide how costly and what type of EHR system to select. EHRs have the potential to bring great change in efficiencies, provide access to actionable intelligence as well as unveil weaknesses in processes. In primary care safety net systems, the information technology area is greatly underfunded. Therefore, improving the IT infrastructure, upgrading staff computer skills, needs and requirements for new hardware and software must be a high priority.

How do you use strategic planning to avoid pit falls?

  • Develop a senior management team and Board of Directors that is committed for the long term financial, infrastructure and human resources needed to make the project successful.
  • Empower the project lead supported by a small team of senior management and staff in key areas. All levels of staff and all departments should have a forum to voices their particular EHR needs and ideas how the EHR could help solve problems.
  • Based on identified requirements, gradually sift down to the top 20, to the top 10, to the top 5 for intense interviews and demonstrations. Invite the staff to software demonstrations.
  • Envision how the organization should look and feel with real-time data for physicians, the ability to generate meaningful reports on quality of care, increased continuity of care by better communication among providers and registration is simplified. Translate that vision into the software selection.
  • Review and map work flow processes. Anticipate weak points in performance that will need addressing and obsolescence of some processes requiring retooling current staff.
  • Think thru costs for enhancements, on going training of new staff, training for “super users” connectivity for e-pharmacy, e-billing etc.
  • Gather and share lessons learned from other organizations that have implemented EHRs. Anticipate and prepare for organizational change.
  • Have a two way communication process with staff that is responsive and factual.
  • Identify physician, registration, nursing, and finance staff champions.

What is the end result?

  • Staff leadership support through meaningful participation in setting requirements, selection process, training schedule and roll-out configuration.
  • Improved patient data and work flow to improve patient care.
  • Visible commitment from the Board and senior management.
  • Financial impact well defined in business model for long term sustainability
  • Retrained staff
  • Elimination of non-productive processes
  • Information driven efforts

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