EHR Selection and Implementation Success: Common Q & As

Implementation, training, and selection of your Electronic Health Record (EHR) come with lots of questions. There are hundreds of vendors out there and a slew of sometimes confusing information. Not to worry-- we've collected our most-asked questions for you. With the right information, you can make your EHR implementation and selection a success.

How Do I Choose a New EHR? 

When you’re about to take a long trip, you want to know what lies ahead. The same should apply for choosing a new EHR solution. A roadmap, or plan, before you begin the stretch of changing EHR systems will be critical to staying organized and completing each step. Successful roadmaps include all tasks and processes that need to be completed by agency staff. 

When you choose a new EHR vendor, here are some initial questions to think through:

• Why is your organization moving to a new EHR?
• What is the budget for the project?
• When would you like implementation to occur?
• What features is your organization looking for in an EHR? You may want to prioritize these features from wants to needs.

Before you can implement an EHR, you must evaluate EHR solutions to make sure your organization’s priorities and needs are met. Some organizations develop a scoring system in order to rank the EHR systems they are considering. From there, you could narrow down the vendors and have your staff vote on the one they prefer. At the end of the day, the most important people to be on board with your new EHR are the people who will be using it everyday. 

How long does it take to implement a new EHR?

Depending on your health organization, implementing an EHR can take 30 days to several years. You must be prepared for a significant– and exciting– change in your organization. Here are a few steps needed to implement an EHR, from consideration stage to the go-live day. These should be considered when trying to figure out how long implementation will take for your health organization. 

1. Data Migration: Patient demographics are often transferred to the new system from paper or another EHR. Clean, quality data is especially important to transfer to a new system to avoid duplications or deleted information. Talk to your potential vendors about their requirements to migrate data, the process, and any associated costs. Not all EHR vendors are created equal– some vendors have bulk upload, which can save a lot of time, though many do not.
2. Transition and Implementation: It takes time to transition from old processes to a new system. Make sure your staff is prepared to set aside additional time for this transition and implementation. Your organization may consider appointment changes, shifts in schedule, etc. A strong team of people, consisting of your vendor’s training team and your internal staff, will support your organization and this transition to ensure success. 
3. Training: Block time for your staff and clinicians to be fully trained, meaning that they have practiced multiple training scenarios. Your vendor may also provide extensive, onsite training to ensure all users are well-versed in the new system. In addition, some EHR vendors will send out a small team to provide pre-live presentations and practice sessions, along with post training activities. These training sessions help the external team understand the day-to-day schedule and workflows of your staff so that the go-live goes smoothly. A handful of dedicated staff members (like super users) who learn the full system can also be tasked with teaching the system to others once the formal training is complete. 
4. Go-live: The “go-live” day refers to the day the EHR software is up and running at your organization. There are real clients who come for appointments, and staff can use the solution for billing, scheduling, encounter notes, clinic management, record keeping, and more. This day may be a little nerve-wracking, but if your EHR vendor has prepared you well, it will go smoothly.

What is the first step in EHR implementation? 

Once you have selected your EHR vendor, your vendor typically will reach out and plan a project kick-off call. This meeting discusses the next steps to implement the software into your organization. Project expectations, like timelines and schedules, will also take place. This call should include your EHR project team. 

After the kick-off call, you can start the implementation process in one of two ways: the “Big Bang” method or the phased approach. The “Big Bang” method refers to rolling out all functionality (billing, EHR, clinical documentation, data migration, etc.) all at the same time. This is usually used when changing EHR systems, as your staff already have a working knowledge of EHR software. A phased implementation means that your EHR vendor rolls out all functionalities step by step, according to your health organization’s capabilities. This is typically the process when your organization is coming off of a paper system, or a separate billing system. Communication with vendors is key to make sure EHR implementation and selection is a success, and happens in the way that fits your team best.

Who is involved in EHR implementation?

When transitioning to a new Electronic Health Record (EHR) system or even beginning to use one for the first time, every health organization needs a team of people to make their EHR implementation and selection a success. Implementing an EHR system is a big change in an organization, and it will impact staff in different ways. A strong team of people, consisting of your vendor’s training team and your internal staff, will support your organization and this transition to ensure success. 

Your Vendor’s Implementation and Training Team

Some EHR vendors prioritize in-person training to help the health organization learn hands-on. Sometimes, an EHR vendor will send out a small team to provide pre-live presentations and practice sessions, along with post training activities like user focus groups. These training sessions also help the external team understand the day-to-day schedule and workflows of your staff so that the go-live goes smoothly.  

Vendor-hosted webinars are another great way to provide relevant training to your staff to practice navigating the new interface and trying out all the features.

Internal Health Organization Leaders

Your internal staff know best about the day-to-day operations of your health organization. They know your workflows, your strengths and potential opportunities, and most importantly, your people. A trustworthy, internal team of assigned EHR leaders is a great practice to make sure your EHR implementation and selection is a success.  

• Super User: In large health organizations, a super user is appointed from the staff to verify that the system is configured to meet your specific organization's needs. Super user training is conducted prior to conventional training for the rest of the staff. 
• Champion: A champion on the internal health organization’s team is usually a medical officer or lead clinician or physician. Their role is to be the liaison between the project team and senior management. 
• Project Sponsor: This is a member of the staff who is usually the administrator or another executive of your health organization. Oftentimes it’s whoever purchased the system. 
• Project Manager: The project manager is a member of the health organization who is the primary point of contact between your organization and the EHR vendor. They are the liaison and have a key position during implementation, as they communicate on behalf of the organization and their needs.  
• Transition Leader: Transition leaders are members of the health organization who specialize in billing, administration, and data analysis. These individuals lead the functional areas of EHR implementation. 
• Inventory Specialist – If applicable, an Inventory Specialist will need to be assigned to someone who handles vaccines, medications, and inventory. In many cases, this is a nurse in the clinic.
• Lead Biller – The Lead Biller is often the only biller. This role will be taken by someone who is in charge of billing at your clinic.
• Subject Matter Experts (SME): Subject Matter Experts know the most about the health organization’s programs and workflows, like billing, administration, clinical service programs, IT, and data functions. In smaller organizations, they also wear the hat of transition leader. 
• Site Leader: Some health organizations have multiple locations. In that case, a site leader is appointed to transition the EHR to all locations of the practice to pass along correct information to staff. 
• Executive Leadership: Individuals in the health organization who are executive leaders are stakeholders that need to be informed in each step of the EHR implementation process. These people have knowledge that contributes to your health organization’s success by making decisions, or can even just be cheerleaders for your staff. 
• Health Department Staff/Users: The everyday users of the EHR are ultimately the ones that must be comfortable and knowledgeable about the implementation process. Their job is to practice using your new EHR software before go-live and to stay dedicated to implementing new changes when they arrive. 

What is the key to EHR implementation and selection success? 

The key to EHR implementation success is communication. EHR vendors and clinicians alike must have open communication during the implementation process. From the beginning of the EHR partnership, implementation best practices include establishing strong internal and external communication. Transparency between EHR vendor staff and all practice staff increases efficiency and eases the transition.

• Internal Communication – Establish strong internal communication to keep your employees up to date even through the EHR selection process. Recognize that a new solution is a big change. It is helpful for staff to feel as if they’re involved along the way. Some practices update their staff in newsletters or on a bulletin board. Communication along the way eases the transition when implementation begins. 
• EHR Vendor Communication – It is important to clearly communicate with your vendor during the selection process and pre-implementation period. Make sure they are aware of the scope of the project. Consider if your program will need custom features, such as special reporting or new development for the software. Talk about the solutions your organization needs to meet your day-to-day workflows. Communicate about training: How do they train? How long will it take to train your users? What ongoing support is provided once formal training is complete? Communicating about your needs throughout the process will ensure a smoother transition to new software.

Additionally, if your vendor team is coming onsite for your go-live day or training, clearly communicate any expectations. Clearly stated expectations will allow both your EHR vendor and clinicians to make your goals attainable. Make sure you have designated super users that will be the first to learn the software more in-depth and help other staff members even when your EHR vendor training teams are not on-site. These super users should continue a close relationship with your vendor, staying up to date with any product patches or changes and continuing to train the rest of your staff. They will often be the best ones to be in close communication with your vendor even after the implementation process.

EHR implementation can be an overwhelming process. There are many steps that go into changing software, so it’s critical that you and your staff have support during the adoption process to make EHR implementation and selection a success.  

“Learning an EHR is like learning a musical instrument - it takes practice, playing time to get comfortable, and ultimately get good and pick up speed. Folks need to just be patient and think about it as a skill that they’ll eventually get better and better at.”

Don Sargent, Vice President of Customer Experience

With great support on your side, implementing a new EHR into your health organization can take your community services, workflows, and to the next level. Your implementation and EHR selection can be a success! For a real-life case study of a successful EHR implementation, read about Cleveland County Health Department’s tips from selection to go-live. 

Send us a message if you have any other questions regarding EHR implementation. We are here to help!

About Patagonia Health, Inc.

Patagonia Health is a living Electronic Health Record (EHR) software designed to meet the complex needs and desired health outcomes of Public Health and Behavioral Health organizations. Our federally certified, easy-to-learn platform includes integrated practice management and billing software so you get one end-to-end solution. Employee-owned and organically grown, our mission is to support your business with software and service that allows you to provide your patients with the care they deserve. If you’d like more information about our solutions, contact us today.