Top Ten Ways to Avoid EMR Implementation Potholes - Cover

Top Ten Ways to Avoid EMR Implementation Potholes

For KLAS’ recent report,  Implementation Potholes 2015: How to Smooth Out the Ride, we interviewed healthcare providers, vendors, and consultants to determine which EMR vendors provide the smoothest implementations and which potholes each of the vendors’ clients can expect. 
As part of the report, we asked what best practices providers should employ to make the transition as smooth as possible. Our top ten findings are below:
  1. Keep It Safe: Providers suggest that implementers consider going over their organization's weaknesses with their vendor to facilitate an implementation-safe environment. Discussing organization weaknesses will encourage the vendor to open up about their own weaknesses and potential pitfalls that may arise during the implementation.
  2. Measure Progress and Concerns: Another way to encourage open discussion with vendors is to provide consistent feedback on their performance in the form of score-cards and to encourage them to share feedback as well.
  3. Remember No Vendor Can Transform You: Vendors repeatedly stress to KLAS that they can’t transform an unwilling organization. They stress that an attitude of change within an organization is essential for a smooth transition. Proceeding in an implementation without complete buy-in at all levels of the organization is a mess waiting to happen. Often, organizations can have an attitude of rushing to hit deadlines. Attitudes like this set organizations up for failure.
  4. Set the Right Timelines: Vendors need to help providers understand how the organization will run differently because of an implementation project, and that understanding takes time. Timelines can be the enemy when the project is centered on hitting deadlines and not adopting true change. A better attitude is to plan to go live only when the organization is truly ready.
  5. Remember the Past: Firms also stress the necessity of taking an honest look at the past successes and failures of an organization and vendor. Taking this perspective helps both organizations and vendors develop realistic expectations of what the end result of an implementation will be. A close look at what successes and failures an organization has had in the past can show providers where they are likely to succeed or fail in the future and allows organizations the opportunity to address potential issues.
  6. Know Your Vendor: Understanding what a vendor can and cannot do in regard to an implementation sets realistic expectations for what the implementation process will be like. It is also important to take a close look at the capabilities and limitations of the system being implemented.
  7. Engagement at All Levels and Especially Engage the Brain: Utilizing the most informed and knowledgeable person in an organization can go a long way toward preventing pitfalls in an implementation. Organizations need to find the bandwidth to allow this person to commit to the implementation as his or her full-time responsibility. Also ensure that the chosen resource is the most knowledgeable about the system. 
  8. Engage Middle Management: Providers must create and maintain a safe environment for the vendor to alert them when they see issues with the competency of middle management and encourage vendors to not only raise a flag but also engage with the middle manager that is creating problems. The middle manager may just be in the wrong role for the specific implementation.  Middle management must be bought in to the new systems and processes because they are probably the ones who created the processes and workflows being replaced. There will be sensitive egos, but getting middle management on board is crucial. If an implementation falls apart anywhere, it is usually with middle management because they designed the processes that are being replaced.
  9. Transform the Organization from the Top Down: Although CEOs and CFOs may have had a role in getting a new system live, when it comes to the implementation and training, many organizations find a correlation between the executive team’s involvement and the implementation’s success. Beyond just testing of the system by frontline providers, it is important to make sure the intricacy of the system is felt all the way up to the top. Executives should experience the training before the rest of the organization. Having the executives experience the training firsthand prevents the thinking that good enough is okay and will help organizations make the experience as easy for the end users as the executives would want it to be for themselves.
  10. Bring In a Third Party: Providers who have a firm playing a significant role in their implementation rate their overall satisfaction with their core EMR vendor five points higher (on average) than those who don’t utilize a third-party firm. These firms are often involved in providing key leadership, tools and methodology, and a team of consultants. While third-party firms at times slow down implementations and increase overall costs, they increase the likelihood of seamless and successful go-lives.