Maintain

Simply implementing health IT is not enough to guarantee results. There is ongoing work required of everyone in the practice to ensure optimal use and return on investment. To keep your new or enhanced electronic health record (EHR) system in good working order, here are a few suggestions and practices to consider making part of your normal day-to-day business routine.

Review and improve your EHR-related processes and procedures on a continuous basis. We recommend formalizing this task and have it include things such as asking for written input from your staff. Keep track of suggestions for improvements and post them in a way that’s visible to your staff. By encouraging staff review, comments and participation, you improve your ability to monitor and refine your EHR-related process.

Revisit project goals and measure progress according to specific performance indicators. The following list can help guide your metrics.

• Informed and committed staff
• Use of optimal practice workflows
• Increase office staff productivity
• Revenue increase (e.g., patient volume, reduced administrative denials, increased reimbursement)
• User training for all staff
• Use of system by all staff for daily tasks
• Reduction in unbilled services
• Improved uptake in chronic disease management
• Reduction in calls with pharmacies and benefit managers
• Patient adherence to prescribed course of therapy and preventive care recommendations
• Patient satisfaction (i.e., improved patient retention)
• Supply savings

Know that any changes you make to your EHR system can affect multiple aspects of your practice. Be sure to have a process in place for considering, implementing and notifying others throughout your practice whenever you or your vendor make any changes.

Vendor participation
There will be times when you will need help from your vendor. There may be a software malfunction, or you may have made an error from which you are unable to recover. In these and other instances your vendor’s responsiveness and technical assistance are critical. Get to know your vendor’s technical support and service processes before a serious event hits your practice. Test out their technical support with smaller incidents so you know how to use it should a serious situation arise. Having familiarity with the process can help you better manage your vendor’s performance as well as your own expectations.

Suggestions and things to keep in mind when managing vendor relations include:

Does your EHR allow you to develop your own documentation templates? If so, you may want to develop more templates or customize the ones that you have. For example, you may want to change the wording or formatting of the forms and letters generated by your EHR. Or you may want or need to change your order sets as medical knowledge advances or your practice, hospital, lab or other entities change their service offerings. Remember to adopt a simple governance process for approving, applying and communicating to your practice staff when changes to your EHR system occur.

What about system upgrades? Your vendor may offer additional, extra-cost capabilities as upgrades to your initial EHR configuration. Many of these can be quite valuable, such as a patient portal and connection to your local Health Information Exchange. As with your original EHR selection decision, you will need to evaluate the total cost of any new module and compare that to the benefits that you will derive from its installation.

What about system patches? Vendors periodically release these and, depending on the EHR you have as well as your service contract, they will instruct you on either how to apply these changes yourself, or they may do the installation for you. Note that this process may or may not require some system downtime or retraining of staff.

What about general hardware support? Regardless of the type of EHR you have implemented, you are reponsible for supporting some type of hardware and network in your office. That means you need to plan ahead to prevent and/or address hardware failures, and backup your data on a regular basis. Consult with your vendor and/or IT services company to determine best practices. Have a plan in place as hardware and networks do fail—and often at inconvenient times.

Are there additional resources I should be thinking about? Absolutely. To supplement your vendor’s support, consider turning to an online user group. These groups are common to most vendor systems and can be very helpful. It is definitely worthwhile to join the group when you are a new user, so you can learn from other more experienced users. Also, more and more vendors offer webinars free of charge. These are an excellent way to learn about upgrades and new modules.