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Addressing Common EHR Implementation Problems

June 18, 2010

Tammy Geltmaker, RN, BSN, MHA EHR Consulting Manager, Health Care Excel

Bonnie Hollopeter, LPN, CPHQ, CPEHR, CPHITProject Manager, Ohio KePRO

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Staff Resistance

Establish a strong project team– Physician champions – Other motivated practice staff

Communicate the value of the system to staff– Demonstrate benefits on an individual level

Identify staff concerns – Develop plans for addressing them

Maintain staff involvement– Throughout implementation process

Manage expectations – Establish realistic goals – Provide quick wins– Demonstrate progress

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Training

Make it relevant– Tailor sessions to staff roles and responsibilities

Engage participants– Ensure sessions are task-oriented and hands-on

Allow for self-discovery– Provide staff with time to “play” with system outside of

formal sessions Create “super users”

– Ensure they receive additional training Develop aids to support staff learning

– Cheat sheets, quick reference guides, etc.

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Project Management

Clearly define scope of work – Before completion of contract

Develop detailed project plan– Include specific steps and responsibilities

Ensure sufficient allocation of resources – Both practice and vendor side

Identify project risks – Develop plans to mitigate them

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Workflow Automation

Map out workflows – Identify problems or bottlenecks

Determine how system can be utilized within processes– Identify potential problems

Re-map processes– Address identified problems

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Interfaces

Allow sufficient time for installation and testing– Build the time into the project plan

Consider various contingencies– Make sure test plans cover different scenarios and

situations Evaluate the effect of typical message loads or

cycles on system– Allow for any necessary modifications

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Handling of Paper-Based Information

Coordinate decisions on key information– Determine information and documents that need to be

entered into system Establish process for data entry

– How information will be entered into the system Determine process for handling new outside

documents Allocate appropriate resources

– Hardware and staff levels should align with information input volume

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System Performance

Evaluate hardware– Ensure minimum requirements

Load test system – Evaluate effect of typical number of users

Evaluate network capabilities– Test network to determine how it handles increased traffic

and utilization Implement system maintenance procedures

– Ensure that they are in place and working

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Contingency Planning

Ensure that disaster recovery plan is in place– Make sure the plan is practical and appropriate for your

office– Conduct drills related to possible emergency scenarios

Test system restoration process– Verify ability to restore system from backups prior to go-live

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Implementation Approach

Gauge physician preferences– Determine amount physicians are willing to reduce

productivity levels Evaluate staff perceptions

– Receptiveness to system, strength of project leadership Develop rollout of system modules or functions

– Based on desired productivity and receptiveness levels Incorporate appropriate training into plan

– Ensure amount of training matches implementation approach

– Make this training “mandatory”

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Questions

Telephone: 502-454-5112 Fax: 502-454-5113 E-mail: tgeltmaker@hce.org

All material presented or referenced herein is intended for general informational purposes and is not intended to provide or replace the independent judgment of a qualified healthcare provider treating a particular patient. Ohio KePRO disclaims any representation or warranty with respect to any treatments or course of treatment based upon information provided.

Publication No. 931300-OH-1256-6/2010. This material was prepared by Ohio KePRO, the Medicare Quality Improvement Organization for Ohio, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy.

Ohio KePRORock Run Center, Suite 1005700 Lombardo Center DriveSeven Hills, Ohio 44131

Tel: 1.800.385.5080Fax 216.447.7925

www.ohiokepro.com