1. Develop an effective change management strategy that includes staff and providers at all levels of the organization. Executive leadership, management, providers and front-line staff are all key players who need to be engaged with defined roles and responsibilities during and after implementation. An engaged team willing to support the change is the biggest contributor to successful adoption.

 

2. Identify executive sponsorship. The engagement of leadership helps everyone move through the change process and ensures a consistent message to your staff. If leadership is not on board with the change, the staff will be reluctant to support it. Providing leadership with the tools to help reinforce the change improves their ability to engage staff.

 

3. Dedicate front-line clinicians and providers to lead the change. Front-line staff and providers are the key influencers of their peers and will recognize enabling factors and identify potential barriers before they are operationalized. They are the best source of truth when it comes to assessing adoption.

 

4. Conduct workflow analysis and redesign. Existing workflow issues, if not addressed, will become more visible with technology. Utilize the technology to eliminate redundant, time-consuming processes and consider re-engineering staff roles and responsibilities that are replaced by the technology.

 

5. Plan out-of-the-box communication and marketing strategies. Organizational change is becoming more frequent resulting in the need to continually evaluate and revise communication strategies. Communicate the overall benefits of adopting EHR technology and help each member of your staff understand how they will personally benefit by it. Informed staff and providers are more likely to stay engaged and work together to achieve success.

 

6. Define and execute a metric plan to measure results. Clearly define and communicate the factors critical to success and create a metric plan to gauge success and improve your processes after the EHR has been implemented.

 

7. Define and execute a metric plan to monitor adoption and identify follow opportunities. Utilize metrics to monitor adoption and focus on areas of opportunity for further education, system, and/or process redesign. Staff will likely not remember everything that is taught. Metrics allow you to identify and intervene with individuals who may be struggling with the transition and/or help prioritize areas of intervention.

 

8. Use an effective, repeatable optimization methodology. A repeatable methodology to address issues and opportunities allows for a consistent, efficient process. Executives, management, clinicians and providers will be accustomed to a consistent methodology and are more likely to embrace it when they understand and can anticipate it.

 

9. Integrate with your clinical IT roadmap.  Expect that optimization will be an ongoing need and efforts will still be needed after the initial “go live” to make it stick. Existing technologies will be constantly replaced with new and improved enhancements, and/or opportunities to improve initial design will be realized. Allocating optimization resources on the strategic roadmap and budgeting process will ensure resources are available to support existing technologies, while new required functionalities are being implemented. Clinicians and providers will have an understanding that there is a dynamic process in place to address their needs.

 

10. Engage highly trained staff to execute the methodology. Ultimately, success depends on having well-trained, well-prepared staff not only inside your practice or institution, but also having an expert team on hand with deep experience in EHR implementation, optimization and adoption. Engaging proven professionals to assist with your efforts and train your staff on a repeatable proven methodology will ensure you are in a place to satisfy your clinicians and providers, serve your patients, and meet regulatory standards.

 

In summary, success is all about the people you have on your clinical adoption and optimization team using a reliable methodology.  You must intentionally manage the cultural, behavioral and organizational changes that need to happen to make the EMR fully functional and gain the intended value. At HCI, our experienced team understands this and can provide a methodology and appropriate resources to ensure adoption and success with your efforts. For information on our expert clinical adoption and optimization resources, please call Marci Denn, Chief Clinical Information Officer and VP of Patient Services, at 407-704-0531 or email her at Marci.Denn@theHCIGroup.com 
 

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Being well-prepared for the launch of a new electronic health record (EHR) system goes beyond having the right system and a well-tested build in place — hospitals must have the right floor support resources available to manage the needs of the clinical and ancillary staff. Go-Live team members must be capable of providing both solid technical expertise and high-quality customer service during those first critical weeks.

As you begin to plan for your EHR go-live, you will need to consider how much staff training has been accomplished prior to the go-live and if you will be able to contribute internal full-time super users during back-load and activation.

Understanding training and available resources at your facility will greatly impact the numbers, type and requirements of the resources you will need to augment your project. The idea is to accomplish your goal, cover hot spots and maintain patient safety.

It’s always better to slightly overestimate your support needs and have the contractual flexibility to draw down resources as project leadership determines.

Consider these three important aspects for a positive go-live experience, which will help your organization get the most from your go-live resources:

1. Perception is Reality

At-the-elbow support resources are the front line for the hospital staff and the face of your project. How will your resources be perceived by hospital staff? Your resources must be knowledgeable in their modality and radiate a teaching spirit.

If your resources struggle technically or lack the ability to connect with more difficult customers, you will most certainly be asked to replace that resource.

2. Be a Problem Solver

The best go-live resources have strong problem-solving skills. Every build is unique and it is imperative that your resources work to get to the root of each problem.

It is not realistic to expect that your resources know everything, but they should be eager to uncover the issues, be specific and report through the communication process to ensure the customer’s concerns have been addressed. If possible, the resource should follow up with end users.

3. Keeping Busy

After the first week it is normal for there to be lulls in support activity. Acuity will begin to rise; nightshifts and weekends can become a little slower for floor support resources. It never fails — there is always someone caught hanging out in the lounge, texting or disappearing for long periods of time.

Resources must be trained on creative ways to fill their time productively. For example, a useful resource will approach staff and ask for permission to either sit alongside or work at the bedside so they are able to watch how the clinician engages the system. This approach creates opportunities for the resource to provide tips, guidance and shortcuts to help the clinician to complete their work more efficiently.

Overall adoption rates are much faster on floors with strong and engaging support. As part of The HCI Group go-live recruitment process, we actively screen resources to exceed these expectations. HCI has an active, tenured network of resources available to provide classroom training, instructional design and at-the-elbow support for clinicians and ancillary staff.

If you would like more information about resource planning for an upcoming go-live, upgrade or training project please contact Randy Grams, Vice President, Client Program Design and Deployment at The HCI Group. Randy can be reached at 904.224.9374 or you can email randy.grams@thehcigroup.com.

The HCI Group is always looking to add exceptional talent to our go-live resource team. If you feel that you bring extraordinary knowledge, skill and abilities, you are welcome to contact The HCI Group’s go-live department for more information about our screening process and to see if you qualify. Call 855-265-9875 for additional details.

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The push for electronic health records (EHRs) to be more widely adopted and used in ways that have greater impact on improvements in patient care continues with the release of the Meaningful Use (MU) Stage 2 rules last month.

In addition to building on the core objectives established in Stage 1, this stage calls on clinicians and hospitals to:

• Further increase the interoperability of health information
• Use more standardized data formats
• Make their EHR systems more capable than the current Meaningful Use Stage 1.

At the same time, it offers important improvements on the rules defined in Stage 1, including:

• More details and
• More reasonable timeframes and
• A phased approach that facilitates a more achievable path to compliance.

A more defined set of rules

Stage 1 Meaningful Use defined a set of 15 objectives providers must meet as proof of their effective use of EHRs, plus another 10 criteria from which five must be demonstrated. To qualify for the stimulus payments in Stage 1 of the EHR incentive program, medical providers need to complete 20 Meaningful Use criteria.

In Stage 2, almost all of the core objectives from Stage 1 are maintained. Hospitals and Critical Access Hospitals (CAH) have to meet or qualify for an exclusion to 16 objectives and two of four menu objectives;. For Eligible Professionals (EPs), the requirement is to meet or qualify for an exclusion to 17 core objectives and three of five menu objectives.

Among the changes in Stage 2 is a better defined set of rules, plus greater clarification of the Clinical Quality Measure (CQM), which should help ease some of the reporting burden healthcare providers must manage.

So what are the major changes from Stage 1 to Stage 2?:

• The requirement to “perform at least one test of certified EHR technology’s capacity to electronically exchange key clinical information” in Stage 1 has been re-evaluated for the possible inclusion into the “transition of care” core objective or eliminated altogether.
• Providing patients with an electronic copy of their discharge instructions at the time of discharge, upon request, has been replaced by an electronic/online access core objective.

Providers who don’t meet their core objectives and menu items are required to meet at least one of these
Final Rule exceptions:

1. The lack of availability of Internet access or barriers to obtaining information technology (IT) infrastructure.
2. A time-limited exception for newly practicing EPs or new hospitals that otherwise won’t be able to avoid payment adjustments.
3. Unforeseen circumstances such as natural disasters that will be handled on a case-by-case basis.
4. EP-only: Exceptions due to a combination of clinical features limiting a provider’s interaction with patients or, if the EP practices at multiple locations, lack of control over the availability of certificated EHR technology (CEHRT) at practice locations constituting 50 percent or more of their encounters.

How HCI helps client overcome the barriers to obtaining IT infrastructure

For clinicians and hospitals facing inadequate access to IT infrastructure, a solution that will help them meet Meaningful Use requirements involves more than simply purchasing one of the hundreds of electronic medical records systems that are on the market. Full compliance in demonstrating meaningful use may require workflow changes to accommodate EHR programs, integration of existing systems with the new programs, and ongoing support with IT complexities encountered as subsequent stages are introduced and regulations and policies continue to change.

At HCI, our clients are partnering with us for the expert healthcare IT consulting and resources they need to help them achieve Meaningful Use and overcome IT barriers. With highly skilled experts in every area of EHR implementation, HCI’s team can help hospitals and practitioners meet immediate Meaningful Use needs while positioning them for the stages and changes to come. Our clients call on us for a full range of specialized services, from taking the lead in strategy and implementation to ongoing helpdesk support and clinical adoption.

Dann R. Lemerand, FHIMSS

Executive Vice President,
Sales and Strategy Marketing

In his role as Executive Vice President of Sales and Strategy Marketing, Dann R. Lemerand, FHIMSS, brings more than 14 years of experience in healthcare information technology to HCI. He led the Michigan Chapter of HIMSS as president for five years and has been on the chapter’s board for the last decade. Dann’s leadership in the industry, extensive knowledge of healthcare IT regulations and his own experience as a business owner are valuable assets to HCI’s clients in navigating the current regulatory environment and preparing them for a successful future.  Learn more about Dann Lemerand

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