Implementing HIT

Once you have made the decision to implement an EHR into your practice, you have undergone extensive assessment as well as detailed evaluations of HIT providers. Use all aspects of this knowledge while creating a work plan for the first day you plan to "go live" with the new system. Conduct as much front-end analysis as possible — especially for hardware (it can be difficult to reconfigure network arrangements after the fact) and staff preparation (you will need all hands on deck for this transition).  Transition planning should be detailed, but flexible, too. Prepare for decreased productivity, workflow disruption, errors and roadblocks, initially. Use this section as a framework for issues to consider, and use our tools section to work through detailed timelines, checklists, model setups and patient-notification materials.

Planning workflow processes:  You already have detailed information about your workflow — the way information moves throughout your office, which tasks take longer, which tasks are priorities, and who does what in the office. Use this information to plan out the location of PCs, to assign tasks and to train your staff. 

• Plan your exam room and office setup according to your office workflow. Make a diagram and change, or accommodate, the flow of information from task-base to task-base, accordingly.
• Make a contingency plan for clinical documentation and information retention in case you run into significant problems. A backup plan should already be a part of your system.
• Have a plan for how to handle paper charts, and a system for archiving records. Will you scan charts as they are used, pulling pages to put into digital file and pages to archive? Will you have a person archiving records all day?

Change management: People adjust at their own pace. Be sure to plan how you will work with your staff and your patients through this process.

• Make sure each member of your staff is comfortable with the tasks they will be performing, and that they have practiced them in advance.
• Inform patients long before you actually “go live” that you are planning to move to digital information. Explain that as you transition, things will move slower in your practice, that you will see fewer patients initially and that their patience is appreciated.
• Put signs up in your office, send letters, prepare your staff to answer questions and communicate the change. Plan for complaints. Plan for praise and excited questions.
• Think about how long you want to have vendor-provided tech support and trainers on-site after implementation. Plan financially to use them for extra time, if you need it.  
• Assign a “super-user” staff-person who is more comfortable with the new system to help nervous staff through their first weeks.
• Give plenty of praise and positive feedback to your staff and yourself.