Electronic Health Records

Adoption & Implementation News

A Successful EHR Implementation Is About More Than Go-Live

By Kyle Murphy, PhD

Go-live tends to garner the most attention for an EHR implementation, especially in the event that it does not go well. But many more activities go into a successful EHR implementation that precede and post-date the production launch.

Earlier this month, Emory Healthcare CMIO Julie Hollberg, MD, highlighted the value of at-the-elbow support to a successful EHR implementation. For Hollberg, a key to her organization's EHR implementation was the deployment of physician support services as different departments and sites went live as part of the EHR optimization project.

"I have been the CMIO for four years and the physician champion when we went live with CPOE in the inpatient setting. When we went live, we had bodies everywhere. I jokingly say physicians want help in the exact moment when they want it, not ten minutes before or after," she told EHRIntelligence.com.

The question was put to readers: Is spending more on implementation services the key to EHR adoption success? As the responses show, much more goes into a successful EHR implementation than the resources and activities dedicated to Day 0.

For one reader, EHR implementation hinges on due diligence being done well in advance of go-live:

Yes, physicians and all end-users need quick/now, knowledgeable support because after all, this is patient care/safety that they are dealing with. But please don't just rely on go-live personnel for this. It begins, as previous posts mention, with the collaboration of end-users (physicians, nurses, pharmacists, ancillaries, etc.) to find out what their needs and workflows are. This is an on-going basis. A quality project team is needed to build the system to the stated needs of the end users. The system must be tested thoroughly. Then trainers, who have an in-depth and thorough knowledge of the workflows and possess excellent training/presentation skills are needed to train it correctly the first time. Finally, go-live personnel should not just be hired just because they say they have experience. They should be vetted properly on their knowledge and experience and receive orientation on the particular workflows of that system before go-live starts. If this entire process is not followed, it won't matter how many bodies you have.

—Certified Epic Trainer/Consultant

For another, the success of an EHR implementation is gauged with what follows the initial go-live event:

I'm seeing a lot of mention of training and at the elbow support. While these are essential components, the deeper issue at hand is how to optimize EHR capabilities to streamline data retrieval in a meaningful format for each clinician, and to optimize data entry. This requires a partnership between healthcare organizations and EHR vendors. Your hospital (clinic, etc.) must have a way to identify gaps and quickly resolve those gaps. Those are the wins our clinicians are looking for. Why on earth would we ask our providers to scroll through a lot of "stuff" to get to what is relevant, or click 20 times because of design flaws? We are making strides, but have a long way to go!

—Clinical Informatics Manager

Still another set the value of the EHR implementation to its integration with other hospital systems:

Revenue cycle is also extremely important. Successful implementation requires integrating the clinical and revenue cycle work flows to ensure the process works from patient scheduling through final billing. This will allow for a solid patient chart for quality patient care, but also allow for timely coding, transcription, claims generation, denials management, statement generation and remittance advices after patient discharge. EMRs/EHRs are not strictly clinical systems, they are the entire patient care and financial process.

Strategic Project Manager

Not only is an EHR implementation an expensive process, but it is also an extensive one in terms of what goes into determining its success.

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