Selecting an Electronic Health Record, the Second Time Around

According to a recent report by the Center for Disease Control and Prevention, in 2012 72 percent of office-based physicians reported using any type of EHR system, up from 35 percent in 2007. Though arguments can be made as to whether EHR penetration actually is as high as reported or claimed, pressures remain in regard to the adoption of the technology. Specifically, organizations and providers face pressure to meet regulation and mandates while improving the quality and cost of care through the adoption of said solutions.

Additionally, as reported by EHR Intelligence, healthcare leaders are looking to decease their costs and increase their return on investment, specifically through the use of health IT and associated technologies. Some organizations, which have not received the benefits of promises made about the technology improving their operations are left with little alternative but to seek new solutions that they hope will help them meet meaningful use, gain incentives and improve their operations.

As user satisfaction slips and more practices and health systems continue to evaluate their needs (and determine the first EHR system implemented is not meeting them), many are deciding to make a change, despite a potentially lengthy and complicated implementation. Some recent data suggest that as many as 25 percent of health systems are willing to make the switch to a second vendor with a new product.

Given this potential volume of transition, hurdle s remain in regard to making the switch. In a nutshell, they are: financial concerns/cost; organizational continuity; technical factors(data migration, for example); and getting everyone on board to make the switch, again.

Replacing an EHR is no simple task, as those who have done it once understand. For organizations making the switch to a second (or dare we even say, a third) system must understand a few things. First, and probably most important, is to learn from past experiences and not setting expectations astronomically high.

Also according to EHR Intelligence, there are several ingredients to a successful EHR transition recipe. Quoting the publication, they are:

  • Executive sponsorship
  • Clinician buy-in
  • Project management
  • Change management
  • Data selection and migration
  • Proper training
  • Suitable EHR vendor and solution
  • Realistic expectations*
  • Patience*

(* — these are optional)

However, there are additional factors, some of which go without saying. Identify key stakeholders: as executive sponsorship and clinician buy-in is key to any EHR adoption, this is even more so important the second time around. Stakeholders come from all areas. For example, if a previous or current system was selected only because physicians or admin thought it was the best system, but no one else provided input into the decision, there will likely need to be a change in thinking when making the switch. In other words, identify previous shortcoming and address them. Essentially, learn from your mistakes or you will repeat them.

Understand that change management will be required. Simply put: people hate change, especially when there’s lots of it. Knowing this also means you’ll need to realize that you may likely lose staff over this change. Expect it and plan for it. Even if staff are completely fed up with the current system and leaders decide to address this frustration by changing systems does not mean all staff will be understanding of the constant flux and may try to find stability elsewhere.

Next, decide what data you need to move over. In most cases you don’t need to move everything. Perhaps you learned that the first time around.

Finally, some table stakes. You’ll need to determine the rollout of the new system; when and how. Then decide if you’re going all in at once or if you’re going to roll the system in one piece or department at a time. Of course, it goes without saying that you need to select a system that’s right for you. If you need tools that were not in your first solution, find an EHR that has those solutions. Also, decide what you don’t need in a solution. An EHR doesn’t need to have a kitchen sink for it to be successful in your organization; cut where you can and you may be the better for it. Address issues you had with your previous vendor by sitting down and discussing them with your new vendor. After all, you have the experience now to know which questions you should be asking and you know when you’re being oversold on a solution. Stick to your gut – if the saying, “It’s too good to be true …” begins to resonate, listen to your intuition and press harder for answers to questions you may have previously never thought to ask your future vendor business partner.

Also, perhaps more due diligence on your part is required or interviewing other practice leaders in your sector. Perhaps bring in a health IT consultant to help with the transition. This might be an ingredient to success that may have been overlooked in the past.

Again, don’t make the same mistakes as last time. A little extra money added to the implementation and selection budget for an IT consultant may help your organization save countless time, pain and hassle in the future. And remember, the process is evolving and solutions are always changing, but now you have the experience to keep you in line with your goals.

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