For any healthcare organization, implementing a new EHR is a massive undertaking, requiring both the “hard skills” of technical expertise as well as the “soft skills” of managing change and people. After using multiple EHR vendors and disparate documentation sources that made integration more difficult, our team at Ozarks Healthcare decided to consolidate to one vendor and a “one patient, one record” model. Throughout the process, we gathered a number of lessons learned from the project. Below are some takeaways from our experience at Ozarks:
Get a head start
You can never start planning too early. Even if your Go LIVE date is two or three years away, start planning now.
Balance priorities
Be sure that your IT staff knows that the ongoing implementation is a major priority, but recognize that daily IT maintenance requests as well as other projects and initiatives throughout the organization will not stop. Factor all competing projects and responsibilities into your plan by establishing a clear scope of work boundaries.
Create end user committees from the start
When you address the inevitable pivots, changes, and bumps along the road, you will want input from committees with the appropriate expertise. For example, we set up a Financial Advisory Committee, as well as Physician and Clinical Advisory Committees. They are a great resource and should be formed at the start of your planning process. Your EHR end users have skin in the game and want to be involved from the start.
Educating and training your staff
You want your physicians to understand that an EHR is just like any other tool, and it requires proper training before being used.
- Schedule time and space for education sessions, and consider using online learning modules to accommodate everyone’s time commitments and avoid having to reschedule.
- Super users are not just something tacked on to IT, they are important. Find them early on and make sure you set clear expectations for them. Their roles and responsibilities need to be clearly laid out for everyone.
- You will need teachers. One option is to recruit tech-savvy nursing and medical students. They can quickly become resident EHR experts who support physicians while gaining real-world experience in a clinical setting. It’s win-win.
Managing your team: CIO = Chief Inspiration Officer
This is a long haul project, so watch your team.
Monitor their hours and workload, keep an eye out for implementation burnout, and keep them energized, happy, and healthy. You want them marching exuberantly when you Go LIVE, not limping to the finish line.
After a new training, give the team time to reflect on and apply the lessons they’ve learned. It will help them remember it cumulatively, which avoids having to revisit lessons from weeks prior, which can bloat your schedule and make your team feel like they’re not making progress or worse, they will feel inept.
Start with a bang
Implementing a new EHR is a mammoth undertaking, and its success requires engagement throughout your organization. From the start, people need to be involved, so you need a way to make it fun or worth their while. We did this by having a branding contest wherein every employee submitted a potential name for the project and the winner received two paid vacation days.
The winning name, “Project 20/20 - One View/One Record,” came from our groundskeeper, Curtis. We worked with design to create an official logo, which we put on posters, hats, and t-shirts to make the implementation project as visible as possible, and keep it top of mind for everyone.
Prioritize communication and organizational engagement
Branding and publicizing the project is a good way to raise awareness and interest at the start, however, it will not provide the widespread engagement you need for the long term. Most people won’t understand the scale of an EHR implementation, but they will understand the impact it will inevitably have on how they do their jobs. People resist change, and you’re changing things. To avoid getting resistance at a time when you need adoption, you need people to buy in. You need organizational engagement. But how?
- Focus on the Why: “What” you are doing is much less important than “why” you are doing it. Without understanding why your work is important, why you’re making changes, and why the change benefits them, people won’t buy in. If all people see is what you’re doing, your efforts will seem like arbitrary barriers to productivity.
- Consult with your EHR implementation team: Make it clear what their responsibilities are. Talk to other colleagues about their experience with the personnel with whom they’ve worked to get a better sense of what to expect.
- Work with PR: You need to communicate and amplify both big picture messaging as well as targeted announcements. This is what PR does all day every day. They have the expertise to craft a clear message and make sure everyone hears it in weekly newsletters, posts on social media, in staff forums, etc. It’s the one tuning they can do that nobody else can.
- Plan for fun: Have contests, play games, and do goofy things. Release some pressure every now and again to help keep people sane.
The big day: Going LIVE
- Make it special. Find ways to make the day a celebration for your team—you worked hard to get here!
- Pick a holiday or weekend: We went LIVE on New Year’s, which was a Sunday. On the first day, you will want to test things and work out any kinks, so you want operations to be at a low capacity.
- Ensure that your leadership is visible: Half of life is just showing up, so even on New Year’s Eve, we made sure leadership was present.
- Keep communicating: Set up daily debriefs and calls with vendors and leaders. And as you plan for reduced volumes or extended hours, be sure to communicate this to the community.
- Flood your organization with resources: Ozarks had special hats and vests made for our IT staff, so when someone needed help, they could quickly identify the right people.
- Assign “Hotline Helpers”: This comes back to delegation. Every minute that your IT people are answering the phones and taking messages is a minute not fixing problems and the things that only they can do.
- Establish personal boundaries: Establish boundaries around communications with your IT staff. That means there are times to call and times to respect peoples’ privacy. You don’t want anyone calling the IT staff at home, at night, messaging them on social media, or leaving messages with family members, all of which can happen if you let them.
Implementing a new EHR is a marathon that will be different for each organization. But no matter where you are, your software and your staff will have successes to celebrate and failures from which to learn. Recognizing each will help you make the adjustments necessary to navigate your way through.
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