Electronic Health Records

Adoption & Implementation News

Five ways to avoid repeating mistakes during EHR replacement

By Jennifer Bresnick

- Replacing an EHR that has failed to work well for a provider can be a tough and expensive decision.  Is it worth going through all the hassle of a new implementation just to change a few aspects of your clinical workflow?  Not if you’re just going to repeat the same mistakes that led you to think about making the switch in the first place.  But how can providers understand what has gone wrong and how to fix it?  Following these steps may be a good start.

Creating the wish-list

In the rush to grab millions of dollars in incentive payments and meet the first stage of Meaningful Use, many providers grabbed the first EHR they saw and figured that they would make it work if they had to.  While the eagerness was admirable, the results were less than perfect.  Providers have been feeling the burn for several years now, and a large number have decided to call it quits with their first choice.

But before diving into a new contract, you need to ask yourself some hard questions.  What do you like about your current EHR?  What absolutely must change?  What would be nice to have, but isn’t essential?  In some ways, purchasing an EHR system is just like buying a house.  The wish-list may be extensive, but in the end, there will always be compromise about the bells and whistles. Creating a detailed list can focus the search to a limited number of vendors that are highly rated for your practice’s size and specialty, eliminating some of the less desirable contenders right off the bat.

Assessing the situation from all angles

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A common mistake made by first-time EHR adopters is failing to consider the big picture when choosing a product.  While the executive board may be most interested in the price tag, physicians might focus more on the clinical interface, while mobility might be on the top of the list for nurses.

It might not be possible to please everyone all the time, but it is possible to understand the issues bugging your staff if you’re to make a better decision the next time around.  Encourage your staff members to make their complaints known, and give them the opportunity to show your EHR replacement team exactly what the roadblocks are.  Make your staff aware that while the new software may not be able to smooth over every rough spot, their concerns are being heard and understood.

Keeping realistic expectations

Your staff might be feeling a little jaded when it comes to EHRs after failing to adapt to the first system, but that might be a blessing in disguise.  It means that they won’t have unrealistic expectations about what new software can do for them.  While the 2014 certification criteria demand more out of developers, and software packages may be more advanced now than they were in 2009, there are still some things that remain out of reach.

Providers may have less money to spend on an EHR replacement than they did at first, and may have more in the way of disparate systems that need to be reconciled, which can be difficult and expensive.  Help your staff understand what you can afford in the new system, what advanced tasks they may not be able to perform, and what they will need to change about their workflow to make the most of the software you’re getting.

Rallying the troops for another implementation battle

That doesn’t mean you shouldn’t be optimistic!  After all, you’re buying a new system to fix the glaring errors that have made life difficult under your old EHR.  It will still take time, effort, dedication, and willpower to encourage your staff to make the necessary changes to the people piece of the puzzle, and that takes strong leadership and governance on an executive level.

If your clinicians and administrative staff felt blindsided by the first EHR adoption, it’s important that your implementation activities are broadcast well in advance this time, so that staff members have the chance to get used to the idea of the switch.  Don’t forget to be flexible when it comes to training and educational activities, because your busy clinicians may already be feeling crunched for time.

Reining in the costs and keeping productivity high

Careful planning during the EHR replacement process is the most important thing you can do to prevent a significant drop in productivity and its associated financial impact after the new EHR goes live.  Ensure that your staff is comfortable with the new workflow, new interface, and new technical requirements before requiring too much of them.  Clear your administrative backlogs before go-live, if you can, to give billing, scheduling, and coding staff a clean slate, and ensure that EHR experts are on hand to answer questions or give an extra lesson where required.

Planning and scheduling might not completely eliminate the potential for an adjustment period that costs the organization some money, but building some extra wiggle room into the EHR replacement budget could help cover the gap.  Priming staff for a new workflow, ensuring that your software meets the majority of demands, and keeping spirits high can help turn an initial failure into a long-term success.



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