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Identifying, resolving 3 common gotchas of EHR go-lives

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- Go-live is always an exciting time for hospitals and IT staff. After months of hard work, you finally feel all the work you did will see the light of day and benefit your end-users. It’s also exciting to see all the pieces come together and work to provide the information that the organization needs. However, go-lives also come with their own set of challenges, and those few days can be pretty exhausting.

We all wish that every go-live could be “uneventful” and users could completely adapt to the changes and love the product. But reality is far from it, and based on my experiences with multiple go-lives and, more importantly, multiple software applications, here are the top three challenges (or gotchas!) that you should be prepared for.

Testing: How much is too much?

Testing is an integral part of any go-live. Before we go live with a product, extensive testing happens. And usually it’s not only with specific pieces of the application but also a more integrated test. In spite of all the testing, there are scenarios that are impossible to encounter unless you are in a real life situation.

Apart from the various levels of functional, user, and integrated testing, one other type that is often ignored is whether the application will work the same way as it does in a room with 10-20-30 people testing as compared to 100-500-1000 people using it at the same time.

READ MORE: EHR Use Nearly Universal in Hospital Outpatient Practices

Load testing is something that becomes very important, especially with new products that don’t have much experience with larger customers. It is very important to emphasize to all vendors that they include load testing as part of the testing process which simulates the real-time environment as much as possible. A good load test would ensure that the application can withstand the volume of people accessing it at the same time.

 

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Jack of all trades: Internal IS cross training

Having a good mix of clinical and IT staff supporting your go-live is essential its success. We also know that training end-users is essential before any go-live. The more comfortable your users are with the new application, the better off you will be, come go-live day.

READ MORE: How Health Orgs Realize EHR Benefits, Quality Improvements

While you would like 100 percent compliance with training end-users, often there are cracks that you can fill by providing support materials like videos and cheat sheets that users can often refer back to once the 24/7 support winds down. But it’s important that IT staff who will be supporting the go-live also be trained to have a comprehensive understanding of the application rather than just the specific portion they were working on. This becomes more important when you are going live with an EHR application where there are multiple modules that all your staff supporting the go-live may not be familiar with.

I’m in no way suggesting that the entire IT staff be cross trained with all the different modules (although how nice would that be?) but more in terms of understanding the overall workflow of how the application works across modules. This will give your staff the confidence to support the application, and it will greatly enhance user satisfaction.

During the initial phase of live, most end-users will ask about simple process and how to-type questions, and knowing how the system works overall can eliminate the frustration of having to bounce the end-user back and forth between multiple people.

After live support: When the training wheels come off!

IT supports go-live with full staff on site usually for a week after the go-live date. Sometimes it’s more than a week, depending on the size of live, but it’s not practical for the information services department to have people on site more than one week after the go-live date.

READ MORE: UK Hospitals See EHR Implementation, Data Transfer Issues

While this is reasonable, it’s very important that follow-up happens a few weeks after go-live. It takes users a few weeks to get used to the new system and figure out what works best and what doesn’t. Having a thorough follow-up — not just with super users but rather having people on the floors a few weeks after go-live — will help reduce frustration and improve performance with the system.

I would even recommend having a team of IT staff float around different units (not have the same force during the day of go-live) to collect feedback and help answer any questions. While your super users on the units will help a great deal making the users feel comfortable that the faces that they saw during the first few days of go-live are still around, which in turn will help greatly with user satisfaction.

While there could be many other challenges, this is some of the most common feedback that I have seen across applications. Eventually it’s all about user acceptance and satisfaction while making the best possible use of your IT resources. With the future of health IT ever evolving and meaningful use taking center stage, many healthcare organizations are moving towards implementing new IT systems, and these simple steps with help ensure the success of those implementations.

Kalyan Ramji is Siemens Consultant at Innovative Consulting Group

 

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