Practice Wise 8/26/12

One Project at a Time!

We as a human race are experts at creating our own chaos. Just check out the news on any given day for proof. Less publicly advertised is the chaos unfolding in clinics and hospitals all over the country as they make the move to EHR.

What I find most intriguing is the clinics who also decide it’s prudent to simultaneously tackle other large projects and initiatives. EHR implementation is hard work, just in case you’ve not been down this road yet. It is incredibly disruptive to all organizations. Processes may not radically change, but determining how those processes will be performed takes much thought and effort every time you perform them.

If other initiatives must be tackled, try to stage the projects to preserve the sanity of everyone involved.

Some things to consider when doing an EHR implementation:

1. If you plan on doing a clinic remodel (which might be necessary to accommodate computers and new workflows), do that prior to implementation, not the week of go-live. It’s stressful to move computers around after a day of using a new system. Even having the computers in a different place the next day can cause disorientation and confusion for all users.
2. If you plan to replace your phone system, consider that these, too, are computers. You’ll be learning to use another new tool with complex processes, which can take away the ease of answering a call and putting it on hold. This is another frustration point and can be exasperating. Don’t over exasperate yourself!
3. New computer hardware, and operating systems are likely a must-do item for your implementation. Do not order your new systems to arrive right before you go live on EHR. Your staff are not likely to be network engineers, and the differences between Windows XP and Windows 7 — soon to be the completely different Windows 8 — or Office 2003 and Office 2010 are so vast, it’s another point of disorientation for the staff. There is a learning curve involved in these upgrades, and clinics rarely consider additional training for operating system and Office product upgrades. We all just assume we can figure it out on the fly. This is a bad decision. The loss of productivity when employees are trying to figure out logins (user name requiring a domain\user configuration in W7) has kept staff from being able to log in to their computers. If you are doing a major system upgrade of computers, consider this another implementation and treat it as such. Get training!
4. Other initiatives such as Patient Centered Medical Home may be part of the reason you are moving to an EHR. However, trying to meet all the goals and measures of PCMH at implementation is not realistic. Don’t set yourself up to meet some reporting deadline within the first month (s) of your EHR installation.

EHR implementation can be compared to being pregnant. There is a beginning, middle, and end. In the beginning, you are tired and often feel like you have morning sickness. The first trimester is the hardest. In the second trimester, you start to get your legs under you, your energy starts to return, and you feel less beaten down by the EHR. By the third trimester, you start to see the light at the end of the tunnel, it’s starting to be second nature, the product is making more sense (hopefully), you’ve got good workflows and everyone is starting to forget how hard the first trimester was.

If you are going to tackle multiple projects and initiatives, consider doing them before you get pregnant if they are pertinent to a healthy pregnancy (buying computers for the EHR), or else wait until your third trimester or later when you can handle the extra burden gracefully.

Don’t create more chaos than you’ll already have with your EHR implementation!

Julie McGovern is CEO of Practice Wise, LLC.