If you thought the selection process for EHR systems was intense, wait till you get to implementation! EHR vendors will drive the implementation process, but you must be prepared to keep up. In many physician practices, managing the implementation process is delegated to the office manager, or even the billing manager or supervisor. But don’t they already have a day job? If you’re a clinician, don’t you have a day job, too?
Remember, the EHR vendor is interested in the most expeditious implementation possible so they can collect the initial fees for software, and start charging monthly maintenance fees. So keeping up with this EHR implementation and training process will require FOCUS!
With most EHR systems, the vendor’s implementation processes include the following phases:
- An initial Kick-off Meeting or conference call to discuss the EHR implementation project, the staff assigned to the project (both vendor and practice), the projected time-line and a list of practice responsibilities – if it has not already been provided.
- Delivery of various material such as the Vendor’s typical Implementation Plan, technical guide, hardware requirements (you should already have those!) and other material the vendor typically furnishes.
- A site survey that you conduct to identify all locations where the EHR system needs to be available, and the hardware and software options needed to support the medical practice.
- Conference calls or visits to identify the billing processes that will transition to the new system, the clearinghouse options, data migration from the old system and interfaces such as lab or imaging. You should expect to receive an EHR implementation checklist or spreadsheets that you must complete and return to the vendor.
- Approval of the computer hardware the practice will be purchasing for the system, and a remote check by the vendor once the hardware is installed.
- File “Builds” – based on information from the practice, the EHR vendor will build files and tables to support administrative processes (security, reports, user lists and rights, etc.), Medical billing processes (Charge master, allowable payments from payors, payor contracts, provider information, patient statement and dunning messages, eligibility connections), and clinical processes (templates, clinical preferences).
- Software installation and EHR vendor software testing – the vendor will be very interested in payment around this step, again to get to the maintenance fee period.
- Testing of optional EHR modules: equipment and outside provider interfaces (lab, imaging), patient portal, dictation, appointment reminder systems, e-prescribing and clinical references such as SkyScape.
- Training of medical practice staff and physicians is extremely involved. Training needs to be provided close to the “Go live” date so staff do not begin to forget their training. Once training commences, the schedule must stay on track!
- There will be some training applicable to all staff members such as patient look-up, document management and faxing.
- Medical front office staff will need training in functions such as patient scheduling, registration, patient check-in and check-out, and scanning.
- Providers and back office staff will need training in a host of areas, including progress notes, labs and imaging, referrals, alerts, flow sheets and much more.
- Medical billing staff will need training in claims processing and submission, payment posting, collections and patient statements – just to name a few.
- Practice Testing and system practice – It is important that staff continue to practice in the system after training, but prior to the “Go Live” date. The practice should also go through a regimen of testing the system to ensure that all the functions promised by the vendor actually work.
- Phasing of “Go Live” – the practice and the vendor must agree on any phasing necessary for going live with the system. For instance, will all providers/locations go live at the same time? Will use be phased by application, such as practice management functions first followed by the EHR functions? How should the practice schedule patients when use of the EHR begins?
- Go Live – representatives from the EHR vendor should be on hand for several days on and after the “Go Live” date.
A successful EHR implementation is no accident!
The EHR implementation process requires focus and dedication on the part of both the software vendor and the medical practice. The more preparation you have done, the better your chances of a smooth implementation period. And the better your chances of realizing all the benefits that you’re after as well.
So back to those people with their day jobs. Some organizations have a unique mix of time and expertise. But many medical practices are consumed with the daily operational needs that they already face. Add to that the fact that an EHR system will affect your daily routine in every way, and as such is surely one of the biggest and most impactful decisions that you may ever make concerning your practice.
We always recommend that there be some honest, self assessment done while considering your and your staff’s level of expertise and available time. And to keep in mind the long-term ramifications of these decisions. You can increase your chances of a successful implementation by adding experienced, knowledgeable people to your staff for the project. To that end, and to help you better understand the detailed steps involved, please take a look at our primer for learning more about selecting and implementing an EHR system for your practice. Just download free copy of our 26 page reference guide: The Art and Science of Evaluating, Selecting, and Implementing an Electronic Health Records System.