Electronic Health Reporter

In continuing a series based on HealthIT.gov’s “How to Implement an EHR,” now seems like an appropriate time to seek additional insight into how to prioritize your implementation plan and identify critical tasks to perform when putting your system in place.

As the HIT world continues to reel from continuous change – meaningful use stage 2, ICD-10 postponement and mobile health among the biggies – like any commercial market, there’s bound to be some constant ebbs and flows.

Selecting, and changing, an EHR are bound to happen no matter what else is going on in the market. So, though much of the market may be focused on regulation and reform related to EHRs, there are still practices who haven’t yet implemented, and there are practices that are looking to get out of their current solutions.

According to the Office of the National Coordinator (ONC), “Building an EHR implementation plan becomes critical for identifying the right tasks to perform, the order of those tasks and clear communication of tasks to the entire team involved with the change process.”

Implementing an EHR is really about implementing a change management process: new rules, new ways of doing things and new things to learn. That’s an oversimplification, but it essentially hits the mark.

Setting up an implementation plan (the plan should be in place before the implementation begins) first starts with segmenting tasks into three categories, according to ONC:

• What new work tasks/process are you going to start doing?
• What work tasks/process are you going to stop doing?
• What work tasks/process are you going to sustain?

The three categories help determine the future work environment of the practice; how things will work after the change.

Obviously, if you are moving from an existing EHR, you’re probably going to be more familiar with how things will work once the system is in place, with a few exceptions. However, moving from paper to electronic records means there are going to be a great number of changes that, if not accounted for, may cause some initial hurdles along the way.

Your next steps should include:

• Mapping your current workflow and analyzing how you get things done
• Mapping how the EHR will affect your workflow, and how you hope it will enable you to perform certain tasks or functions like how you plan for them to create more efficiencies and reduce duplicate processes?
• Creating a backup plan to address issues that arise during implementation. This is crucial as issues beyond your control will come up and if you’re not prepared for them, they could derail your process and set you back. Think of worst case scenarios and plan for them to happen then hope for the best. No implementation is ever the same as another; each are there own experiences.
• Building a project plan to blueprint the transition then appoint a team member to manage the plan.
• Identifying data that must be transferred to the EHR either from paper or from the previous EHR (charts are the most obvious example here)
• Finally, find out what can be transferred to the new system like patient demographics and schedules.

Once this point has been reached, you can bring other parties into your plan, like consultants and vendors, to get the plan rolling and potentially start the implementation.

Next, you can begin the selection and implementation or upgrading process, but if you need additional information about planning your implementation or assessing your readiness, read “Assess Your Practice’s EHR Readiness and Plan Your Implementation.”

Otherwise, you’re on your way.