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What keeps the lights on during health IT adoption, support?

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“Lights on” — many of us in the healthcare industry have heard this expression over and over. With all the new software upgrades and overhauls that healthcare organizations go through, this has become an integral part of the process. So what is keeping the lights on? Is it just a fancy way of saying maintain and support existing systems while the organization transitions to a new IT system — or is it a little more than that? Keeping the lights on involves a lot of things that we might otherwise not think about.

- Everybody wants to be in the thick of the action — not act as the behind-the-scenes support whom no one notices. On the one hand, you may not have the same amount of resources at your disposal for support; on the other hand, you also want to make sure that the customer service that is provided to your end-users doesn’t diminish during the time when you have your resources committed elsewhere.

From my experience, I have come to realize that keeping the lights on is a lot more than good old IT support. While it can be boring at times, it can also provide you with invaluable experience in dealing with a multitude of issues and present you with more knowledge than you originally realized. You need people who can perform multiple activities and make quick decisions as you transition toward a new system. Here are some of the challenges faced by people who keep the lights on.

Is the system really frozen?

The first concern that comes to mind when you think about support is that there will be no new developments: Will we support and maintain existing applications while the hospital focuses resources on developing its future IT system?

While this may be true with a lot of industries, healthcare IT works a little differently. In the ever-evolving healthcare space, there are a lot of factors that can alter what a frozen system really is. New requirements from government bodies such as the Centers for Medicare & Medicaid Services (CMS), regulations from Joint Commission, new laws put into effect — all of these can require changes to the existing system in order to be fully compliant. You always have to anticipate such changes, and working on the system constantly with limited resources at your disposal for testing, change control, etc. is a challenge in and of itself.




This word takes on a whole new meaning when you are one of the people trying to keep the lights on. Staffing for backfill support is generally a third or less than what you would otherwise have when fully staffed, and any issue could make it an all-hands-on-deck scenario. This especially is challenging when you are used to a certain specialty or are not used to working on other modules in the system, as you would have to learn to understand and adapt quickly to help resolve the issue.

It is very important to understand that while the organization is undergoing a major change with the IT system, the end-users still have to use the current system. You might find yourself working on many things at once in this scenario, and learning to get out of your comfort zone and work on multiple things can pose a major challenge. There could also be instances where you are the only person available to troubleshoot an issue. Making quick decisions and adapting to the different needs at any given time is definitely a challenge that one has to overcome while keeping the lights on.

Bend over backwards!

Being flexible is a key component in keeping the lights on. You should be able to adapt to the situation and be comfortable with working around the schedules of different people so you can provide your client with the best possible support around the clock. It also means that some days you might be the only person to deal with issues that arise.

How many times have we gotten trouble tickets from users on a Friday afternoon? Probably more often than you care to remember. This goes back to my previous point — you need to be prepared for any contingencies and use a calm and clear head to resolve issues.

There could be times when you might be trying to concentrate on a particular job, and you might have to put that on hold and change your mindset to something completely different that requires immediate attention. The ability to turn off one switch and turn on another is something that you would learn during this process.


While these are some of the challenges that one might face while keeping the lights on, this can actually be an opportunity to enhance your career. This process can give you a more comprehensive knowledge of how the system works, and more importantly, how the process works across different sections of the organization. Having people with such a holistic knowledge of the electronic medical record can help the organization look at the whole picture and analyze where they may have gaps — especially when organizations are moving toward implementing and adopting new EHR systems that work as an all-in-one solution as opposed to a best of breed system.

Being flexible and multitasking is not only a challenge but also an asset when it comes to learning new tools. Having a grasp of multiple workflows in the organization can give you an edge to pick up new systems faster than others. With such knowledge, learning new tools can become easier, and more importantly, applying them to fit your organization or client’s needs would make you more valuable. Utilizing people who have had the experience of supporting multiple applications in your new EHR build can enhance the quality of your build and ensure a successful go-live.

Kalyan Ramji serves as a Siemens Consultant for Innovative Consulting Group.




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