EHR Conversion: Best Practices for Replacing an Existing EHR System

Written by on July 2, 2012 in Practice tips - No comments

Identifying flaws and evaluating EHR technology

By Frank J. Rosello

The healthcare industry today is arguably experiencing the most change and challenges dealing with technology integration than any other industry. Health information technology is at the core of the global transition in healthcare as it’s becoming more apparent that medical organizations will not be able to effectively coordinate care without having real-time access to patient data in order to measure every aspect of care delivery. Today, it’s of critical importance for medical organizations to approach electronic health record (EHR) selection as a foundational aspect of their long-term business strategy in order to effectively navigate the future of healthcare with the emergence of accountable care, new payer models and payment reform. Only recently has there been tangible evidence that illustrates the challenges many ambulatory medical organizations are facing with adopting EHR technology.

A recent KLAS report found that out of 400 providers surveyed, 35 percent are looking to replace their existing EHR system. Additionally, it was reported that more than 40 percent of groups with more than 100 physicians are also looking to change EHR systems. The health IT industry is calling this trend “rip and replace.” Apparently there are needs, service requirements and functionality not being met by some of the existing EHR systems currently in use. Medical organizations that replace their existing EHR system state their reason for moving to a new solution was either due to a lack of needed functionality, lack of product flexibility, issues with customer support, or system implementation and integration failures.

The key to a successful EHR implementation, when replacing an existing platform, is to perform an evaluation by asking the right questions to understand if the problem is the system, the implementation, or both. Here are some questions to consider when performing this type of review:

  • Did the organization commit the right amount of resources to the initial EHR implementation/deployment? Areas to review should include: sponsorship, technology, financial, personnel, time and attention.
  •  Did the organization clearly define the requirements of the EHR system to insure the system purchased had the features, functionality, and interoperability needed to support the operations and workflows of the organization now and in the future?
  • Did the organization purchase or enter into a partnership with a vendor to ensure optimal use of the technology?

Accurately identifying the root cause or causes driving the dissatisfaction with the existing EHR system is paramount in order to move forward with the selection of the replacement system. Unfortunately in most cases, dissatisfaction with EHR systems is directly related to a poorly executed implementation plan. To help medical organizations and providers successfully “rip and replace” their legacy EHR system, consider the following six best practices:

  1. Effective Project Planning – Take what was learned during the evaluation review and incorporate those findings to the new implementation plan. The plan should also include regular communication and updates to the staff and patients. Communication is very important during a transition of this magnitude and can be managed through the creation of a health information management committee and change control board (CCB).
  2. Expect Obstacles – Flexibility is of critical importance during this time of change. Even though a fair amount of experience and knowledge was gained during and post the implementation of the legacy EHR system, recognizing what the potential pitfalls are and developing a mitigation plan ahead of time will go a long way.
  3. Map Out Workflows Before Go-Live – Organizations should consider running a series of mock clinic tests before go-live. Furthermore, the physicians should be intimately involved with designing the templates and mapping out the workflows within the practice. By having physicians engaged to this extent will help to ensure full physician adoption.
  4. Existing Data Migration – It needs to be determined what data will be transferred from the legacy system and in what format. The objective is to capture as much discreet data as possible to ensure the continuity of patient’s medical records and clinical reporting.
  5. Training – Develop a comprehensive training plan that will address multiple learning styles: computer-based, scenario-based, shoulder to shoulder. The training plan should also incorporate competency evaluation and monitoring processes along with regular follow up with end-users.
  6. Post Implementation Monitoring – Once the onsite support and training team concludes their work, successful organizations partner with an outside vendor to monitor the progress of all stakeholders including the physicians, clinicians and non-clinical staff. By having an outside partner monitoring the operations post implementation will help to identify knowledge gaps and suggest workflow improvements that will ultimately lead to a successful EHR system implementation.

An EHR system that is ineffective will ultimately lead to failure in the future. Medical organizations that do not have effective, efficient health information and data management practices today are at significant risk to become isolated and unsuccessful in the future. These best practices are crucial in making your healthcare organization’s transition to a better suited EHR system successful and seamless.

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