Electronic Health Records

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What activities need to come after an EHR implementation?

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Do you long for the day when all of your hard work is put into use, the long awaited go-live is over and your workload will finally slow down? If you have never been through the full lifecycle of an implementation, you may not realize that going live is only the beginning. In fact, many times post go-live work is more than the implementation effort.

What lies beyond implementation? This article is not meant to cause you to throw your hands in the air and run screaming. Instead, it takes aim at preparing you for what comes next.

Cleanup: Once the initial implementation is over, there is still a great amount of work to complete, typically beginning with cleanup. Cleanup may consist of finalizing build components that were put on hold because they were not deemed critical for go-live or modifying the initial build as it did not act according to its intended purpose.

Follow-up onsite visits or training: These are important components of ensuring the full EHR utilization and adoption. These visits require not only the training team’s time and efforts but also those of EHR analysts, all of whom should either conducts onsite visits or work hand-in-hand with the trainers during this period.

EHR optimization builds or requests: As end users become more comfortable using the application, the build optimization requests begin. The first step in tackling the onslaught of requests is to match up similar or duplicate requests and close any requests resolved during go-live or cleanup phase. There may also be requests that can be marked as an “enhancement request,” which indicates that it may, or may not, be addressed in a future release or upgrade of the application. Enhancement requests remain in queue but are given a lower priority in the initial prioritization of optimization requests. Once the list is clean, the next step is to prioritize all requests and establish completion expectations. The EHR team can then blend optimization requests in with on-going support requests.

Implementation of additional applications: After go-live, the organization can address the implementation of additional applications, modules, or functionality. Attempting to implement every available system functionality or module is daunting at best; therefore many organizations narrow the focus of the initial implementation and address added functionality post go-live.

Ongoing production system support: Ongoing support becomes a large part of the organization’s EHR team’s day-to-day responsibilities. Ongoing support is not only working the issue log or ticketing system as problems are identified by end users but also managing issues through change control and providing after-hours call coverage for the production application.

Work on additional projects: For most organization’s today, EHR implementation is only one of many IT projects.  Finally, additional projects that have remained active during implementation — such as ICD-10 implementation, meaningful use attestation, the implementation of patient access systems, rolling out the EHR to community physicians, or implementation of any number of other numerous systems — now take on heightened priority.

At the analyst level, you can simply prepare for post go-live by keeping a log of all those action items you have put on the backburner until go-live is over. This will assist you considerably in keeping organized as you return to work after go-live. The log can also lend its way to sitting down with your manager to prioritize your work and in the end alleviate some pressures to get it all done 30 days after go-live is complete.

At the organization level, preparing and planning for post go-live is just as important as planning for the implementation and go-live of the EHR itself. Determining how this work can and will be accomplished may a challenge, but with proper planning it can be achieved. However, the largest pitfall may be not including the post go-live work in your budget, which is why planning for this post-implementation period, is so crucial.


Jerrilyn Cowper is MHA Application Management Solutions Manager at CTG Health Solutions and a healthcare information technology (HIT) services leader with over 25 years of executive, operational, and consulting experience. 






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