Electronic health records (EHR) will be replacing most “hard copy” medical records in medical facilities – if they haven’t done so already.

Is your nursing home, rehab facility or healthcare clinic prepared?

The Healthcare Information Management Systems Society (HIMSS) in 2010 surveyed physician offices with 1-5 physicians on staff.  They reported on the top 10 EHR implementation practices found, which were:

  1. Communication
  2. Leadership
  3. Education
  4. Goal Setting
  5. Culture Change
  6. Workflow Redesign
  7. Training & System Testing
  8. Implement with Enthusiasm!
  9. Assessment
  10. Celebration

Let’s discuss each briefly.

Communication: The HIMSS study found this to be the “lynchpin” to successful EHR  implementation.  It found that failing to tell your team and staff members about your plan to implement EHR can “lead to rumors flying around the office, which can lead to resistance (fear, uncertainty, and doubt)” .

Leadership: Designate a physician or executive/manager as an EHR implementation “champion.” This person should have the authority and responsibility to make all decisions. All staff should be held accountable, however, for their parts in the implementation.

Education: Read about EHR implementation best practices. Visit other EHR facilities (like your own) to learn what they did, what they did right and what could have been done better. Question your EHR vendor “closely”, so that you fully understand what the significance of any planned enhancements.

Goal Setting: Set SMART goals for implementation (Specific, Measurable, Achievable, Realistic, and Timely). Your goals should reflect the needs and opinions of all team members (physicians, clerks, LVNs, care partners, nutrition staff, marketing staff – everyone) as well as your patients or residents.  Share those goals with your vendor.

Culture Change: Your facility’s entire culture will change after EHR implementation. To make sure it’s a positive change, HIMSS recommends that you be “rigid in your insistence that nimbleness, flexibility, and creativity infuse your implementation process. “ Accept only one long-term response from your staff: “Yes, I will use the system”.  There can be no work-arounds or grandfather clauses for old-timers.

Workflow Redesign: Map out your facility’s “workflow” in regards to staff and patients/residents activities. Truly understand how you see patients from the beginning to the end of the “care encounter”.  Will the new, computerized workflow fit those situations?  The goal is not to necessarily save time, but to make the time more productive and efficient.

Training & System Testing: EHR is computer-based. How well do your staff members work with computers?  Will they require hands-on training?  Assess their skill levels and comfort. In what skills do your staff members need training? Train your staff before, during and after implementation.

Implement with Enthusiasm!  Consider buying T-shirts for all staff to wear, place helium balloons around the practice, or signage welcoming all to the implementation.  Make sure your residents/patients are notified about the implementation – long before the sign goes up – and let them how the implementation will benefit them.

Assessment: “Conduct satisfaction surveys,” HIMSS says. Act on the results and set new goals.

Celebrate Your Success: Celebrate your successes large and small. Have parties for both staff and patients/residents.

To read the full report, visit the HIMSS website.

Have you implemented EHR in your medical practice, out-patient clinic or retirement community? If so, how did it go? What do you feel you did right, and what do think you could have done differently?

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NOTE:  For a full-color, downloadable PDF, click here.