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Electronic Health Records Implementation

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Electronic Health Records Implementation

  1. 1. Electronic Health Records <br />Implementation Planning for Success<br />Presented By: Nancy McClanahan<br />VP Operations Planning Synergies, Inc.<br />
  2. 2. Planning for Success<br />System implementation projects, in general, experience low success rates:<br />28% of project meet full success<br />49% of projects are fully completed, but over budget, over schedule, and lack full scope of planned functionality<br />23% of projects experience complete failure or are cancelled<br />EMR/HER system implementations have even higher failure rates. Industry studies reveal failure rates of 50% others as high as 70%<br />
  3. 3. Planning for Success<br />System implementation projects, in general, experience low success rates:<br />28% of project meet full success<br />49% of projects are fully completed, but over budget, over schedule, and lack full scope of planned functionality<br />23% of projects experience complete failure or are cancelled<br />EMR/HER system implementations have even higher failure rates. Industry studies reveal failure rates of 50% others as high as 70%<br />
  4. 4. Planning for Success<br />Other contributing factors to implementation failures are:<br />Believing the vendor will assume responsibility for all tasks<br />Hoping the vendor/system will fix your operational and personnel problems<br />Fear of change<br />Fear of technology<br />
  5. 5. Session Goals<br />Keep implementations of EMR/EHRs on the right side of the negative statistics<br />Help them think through the key HER implementation decisions<br />Understand the options<br />Understand the risks<br />Position them all to be enable the implementation success <br />
  6. 6. The EHR Adoption Process<br />
  7. 7. Implementation Planning-Steps to Success<br />Establish an Effective Implementation Team<br />Finalize HER Goals & Priorities<br />Establish Implementation Strategies and Scope<br />Develop the Implementation Plan with a Realistic Timeline<br />Emphasize Communication<br />Establish Benchmarks to Measure Project Success<br />
  8. 8. Step 1 – Implementation TeamKey Participants<br />Physician/Clinician Champion<br />Skilled & Knowledgeable Project Manager<br />Network/Technical Analysts<br />Trainer<br />Designers, Builders, Testers & Implementers<br />
  9. 9. Step 2 – Finalization EHR Goals & Priorities<br />What is the vision for the system?<br />What is it to help the practice achieve?<br />Improved care/quality of care for patients<br />Clinician ease & productivity<br />Lower Costs<br />Higher revenues<br />Competitive advantage<br />Be in compliance with Regulatory Requirements<br />Other?<br />Which features & functions support these goals?<br />
  10. 10. Step 3 – Establish Implementation Strategy & Scope<br />Phased vs. “Big Bang” Implementation<br />Incremental functionality vs. full system implementation<br />Phased users vs. immediate full practice<br />Historical Medical Chart Information Needs<br />How much data?<br />What formats?<br />Communication Strategy<br />“Go-Live” Date Constraints & Planning<br />
  11. 11. Implementation Strategy & Scope – Phased vs. “Big Bang” Approach<br />Incremental vs. Full System Functionality<br />Do we want/need all functions available “Day One”?<br />Can we absorb that level of change at one time?<br />Can we take on that level of implementation work at one time?<br />If not:<br />Based on the priorities of EHR/EMR goals<br />Based on the time and resources that can be allocated<br />What functions do we want/need immediately?<br />In what sequence should we add the other functions?<br />Over what period of time?<br />
  12. 12. Implementation Strategy & Scope Example – Incremental Functionality Phasing<br />Viewing of lab and diagnostic results<br />Prescription management<br />Current medications<br />Allergies/sensitivities<br />Telephone messaging<br />Lab and diagnostic order entry/results reporting (OE/RR)<br />Correspondence<br />Medical charting<br />Trending, analysis & reporting<br />Patient management<br />Population management<br />
  13. 13. Implementation Strategy & Scope – Phased vs. “Big Bang” Approach<br />Phased Users vs. Immediate Full Practice<br />Will we be ready for everyone to “Go Live” at the same time?<br />Can we absorb that level of change at one time?<br />Can we support everyone on “Day One”?<br />If Not:<br />Who/What areas should go first?<br />What impacts will this mix of paper vs. electronic have on the other processes within the practice?<br />In what sequence should we add the others?<br />Over what period of time?<br />
  14. 14. Implementation Strategy & Scope – Phased User Considerations<br />Physician Cross-over/Coverage<br />Patients<br />Sites<br />Programs<br />Clinical Teams<br />Nurse/MA support across physicians<br />Maintenance of Mixed Paper/Electronic Charts<br />Labor<br />Error Rates<br />
  15. 15. Implementation Strategy & Scope – Medical Records Conversion Approaches<br />Abstracting and manual entry<br />Scanning<br />Electronic conversion<br />
  16. 16. Implementation Strategy & Scope – Communication Strategy & Approach<br />External<br />Promotional<br />Patient Reaction<br />Patient Perceptions of the Business and locals<br />Fear of loosing the doctor that I see now<br />Ensure the quality of services<br />Internal<br />Employee Reaction<br />Job Loss<br />Role change<br />Technical challenges<br />Stakeholders<br />
  17. 17. Implementation Strategy & Scope – Implementation Date<br />When is the least busy time of the year?<br />Are there key resource constraints?<br />Are there any other practice activities to plan around?<br />
  18. 18. Step 4 – Develop the Implementation Plan with a Realistic Timeline<br />Based on the goals and strategies set for the system:<br />What specific tasks need to be done?<br />By whom?<br />When?<br />How long will all this take to complete?<br />
  19. 19. Develop the Implementation Plan – Conduct Detailed Vendor Planning Meetings<br />Communicate practice vision, goals, strategies & approaches<br />Establish overall project structure & parameters<br />Contacts<br />Escalation<br />Build relationships<br />Confirm requirements<br />Establish agreement on:<br />Task<br />Roles and responsibilities<br />Time Requirements<br />
  20. 20. Develop the Implementation Plan – Documenting the Plan<br />Milestones<br />Tasks<br />Dependencies<br />Vendor<br />Practice<br />Individual<br />Time Requirements<br />
  21. 21. Develop the Implementation Plan – Defining the Detailed Tasks & Responsibilities<br />Medical Records Conversion<br />Contingency Planning<br />System back-up<br />Disaster recovery<br />Interim workflow planning<br />
  22. 22. Develop the Implementation Plan – Defining the Detailed Tasks & Responsibilities<br />Go-Live Planning<br />Patient schedules<br />Support<br />Dress Rehearsal<br />Go/No-Go decision<br />Flipping the switch<br />Celebrating<br />Stabalization<br />
  23. 23. Develop the Implementation Plan – Setting a Realistic Timeline<br />Bottom up Estimation<br />Let the task and Resources drive the timeline OR<br />Provide the resources to support the tasks for the timeline<br />Remember Schedule Constraints<br />Set a “Go-Live” that is Achievable<br />Communicate it<br />
  24. 24. Step 5 - Emphasize Communication<br />Internal Communication<br />Enlist full support<br />Ease concerns<br />Job security<br />Technical learning support<br />Tell them what to expect & When<br />
  25. 25. Emphasize Communication<br />Patient Communication<br />Tell them what you are doing & why<br />Provide consistent answers to questions & concerns<br />Keep them informed on progress<br />Communicate enthusiasm & confidence<br />Include them in EHR success celebrations<br />
  26. 26. Step 6 – Establish Benchmarks to Measure Project Success<br />Measurements based upon goals<br />Increase revenues through improved E & M coding<br />Reduced claims rejection<br />Insurance plans understanding and possibly acceptance of different types of insurance or third party payer services <br />Reduced Expenses:<br />Medical Chart supplies<br />Staff costs<br />Transcription reduction/elimination<br />Increased patient visit volumes<br /> Physician/clinician productivity<br />Additional exam/treatment rooms<br />Improved preventive & chronic care compliance/outcomes<br />Improved patient satisfaction<br />New patient increase<br />
  27. 27. Planning for Success<br />

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