KLAS Arch Collaborative Success Pathway—EHR Changes & Upgrades

Healthcare Delivery Organizations

Optimization Journey: EHR Changes & Upgrades

1. Review self-examination questions and the 2023 Arch Collaborative report Successful EHR Upgrades
2. Assemble a multidisciplinary governance committee for EHR upgrades that includes organization and IT leadership, EHR educators, informaticists, superusers, and individuals with various clinical backgrounds to review, evaluate, and approve proposed upgrades; include individuals from both end-user and leadership levels and a strong project manager who is organized and structured
   1. Empower the committee to test upgrade features and functionality in a sandbox environment to ensure all questions, issues, and obstacles are resolved
   2. Invite additional end users to test upgrades in the sandbox environment and solve any additional issues
3. Based on the governance committee’s tests and information from the vendor (if applicable), determine appropriate timing for the rollout, including the downtime protocol

1. Marshal resources from the EHR upgrades governance committee, EHR educators, informaticists, and superusers to build a communication plan that includes the following:
   1. Description of why you are upgrading the EHR (e.g., regulatory compliance, EHR improvements, clinician change requests), highlighting the expected clinician gains
   2. Timing of the upgrade rollout and the downtime protocol
   3. Specialty- and role-specific release notes, including workflow changes; leverage vendor materials
   4. Multiple methods for distributing communication, including email, rounding, communication in the EHR, team meetings, newsletters, superusers, posters around the building, and townhall meetings
2. Identify who will communicate the upgrade information (e.g., the CMO will communicate with physicians, the CNO will communicate with nurses, etc.)
3. Communicate broadly and well in advance of an upcoming EHR change or upgrade, relying on the plan created in step 1 of this phase

1. Review the Arch Collaborative Success Pathway for ongoing EHR education to ensure success with your EHR upgrade education plan
2. Create EHR upgrade education materials (e.g., tip sheets, videos, PowerPoint modules) based on the specialty- and role-specific communication information developed in Phase 2—explain why you are upgrading, the expected clinician gains, and any new terminology; remove dated/no-longer-applicable education materials; leverage vendor materials
3. Create a path for clinicians to enroll in EHR upgrade education courses and modules and utilize superusers and informaticists for peer education

1. During the upgrade rollout, ensure a team—including superusers, IT team members, and informaticists—rounds to help clinicians, answer questions, monitor downtime, and fix system errors
2. Ensure that clinicians have quick, easy access to EHR educators for more in-depth questions and education than can be provided via rounding
3. A few days after the upgrade, survey clinicians to understand what they feel went well with the upgrade process and what could be improved
4. Empower the EHR upgrades governance committee to conduct a review after the upgrade implementation to review the upgrade process, incorporate clinician feedback, follow up on clinician concerns, and recommend future changes; identify and address gaps in the EHR upgrade communication and/or upgrade education materials

Self-Examination Questions—EHR Changes & Upgrades

On a scale of 1–5, rate your agreement with the following statements (5 means “strongly agree” and 1 means “strongly disagree”):

1. When we make EHR changes or accept upgrades, we plan for application testing, integrated testing, and end-user testing. Our upgrade test plans have detailed test scripts that include not only larger, common workflows but also important, smaller workflows.
2. Our upgrade preparation includes a review of our infrastructure (e.g., equipment, servers, Wi-Fi) to ensure compatibility.
3. We have an empowered multidisciplinary EHR governance committee focused on EHR changes and upgrades.
4. We have established a consistent day and time for EHR changes and upgrades that is well advertised and known throughout the organization (e.g., every third Tuesday at 2:00 a.m.).
5. We have superusers and/or informaticists who effectively communicate with and educate clinicians on EHR changes and upgrades.
6. We have an established communication structure that ensures broad and multifaceted communication for EHR changes and upgrades.
7. We leverage available vendor materials when creating our change/upgrade communication and education plans.
8. Our EHR governance committee, superusers, informaticists, and EHR educators work together to develop specialty- and role-specific change and upgrade communication for our clinicians.
9. We provide comprehensive, specialty- and role-specific education for EHR changes and upgrades.
10. We have a team that rounds with clinicians during EHR changes and upgrades to answer questions, provide guidance, and identify and resolve issues. Our change and upgrade plan includes night-shift support.
11. We proactively survey clinicians after EHR changes and upgrades to understand what is going well with the process and what we can improve.
12. Our EHR governance committee actively makes changes to our EHR change and upgrade process based on their candid assessment of the most recent upgrade and clinician feedback.

Total

Scoring

HIT Software Vendors

Self-Examination Questions—EHR Changes & Upgrades

1. How do you thoroughly vet EHR changes and upgrades to ensure minimal disruption during the change and upgrade process?
2. What infrastructure guidance do you provide to your customers to ensure their current servers, hardware, and Wi-Fi will optimally perform with your current EHR upgrade/software version?
3. Do you advise your customers on when and how to communicate regarding EHR changes and upgrades?
   1. Does your communication include why the EHR is being changed or upgraded and how the changes and upgrades will benefit clinicians?
   2. Do you advise your customers on when to start advertising the change or upgrade?
   3. Do you create specialty- and role-specific EHR communication for changes and upgrades?
   4. Can your EHR changes and upgrades communication be minimally tweaked by your customers to fit their needs?
   5. How do you create end-user awareness of upcoming EHR changes and upgrades?
4. Do you offer free EHR education courses to your customers related to changes and upgrades?
   1. How accessible/searchable is your EHR education content?
   2. How do you ensure your EHR changes and upgrade education content is comprehensive, current, and vetted by practicing clinicians?
   3. Can your EHR changes and upgrades education content be minimally tweaked by your customers to fit their needs?
5. What incentives do you provide to encourage organizations to adopt your most current software release?