1. 1 Addressing Common EHR Implementation Problems June 18, 2010 Tammy Geltmaker, RN, BSN, MHA EHR Consulting Manager, Health Care Excel Bonnie Hollopeter, LPN, CPHQ, CPEHR, CPHIT Project Manager, Ohio KePRO

2. 2 Staff Resistance  Establish a strong project team –Physician champions –Other motivated practice staff  Communicate the value of the system to staff –Demonstrate benefits on an individual level  Identify staff concerns –Develop plans for addressing them  Maintain staff involvement –Throughout implementation process  Manage expectations –Establish realistic goals –Provide quick wins –Demonstrate progress

3. 3 Training  Make it relevant –Tailor sessions to staff roles and responsibilities  Engage participants –Ensure sessions are task-oriented and hands-on  Allow for self-discovery –Provide staff with time to “play” with system outside of formal sessions  Create “super users” –Ensure they receive additional training  Develop aids to support staff learning –Cheat sheets, quick reference guides, etc.

4. 4 Project Management  Clearly define scope of work –Before completion of contract  Develop detailed project plan –Include specific steps and responsibilities  Ensure sufficient allocation of resources –Both practice and vendor side  Identify project risks –Develop plans to mitigate them

5. 5 Workflow Automation  Map out workflows –Identify problems or bottlenecks  Determine how system can be utilized within processes –Identify potential problems  Re-map processes –Address identified problems

6. 6 Interfaces  Allow sufficient time for installation and testing –Build the time into the project plan  Consider various contingencies –Make sure test plans cover different scenarios and situations  Evaluate the effect of typical message loads or cycles on system –Allow for any necessary modifications

7. 7 Handling of Paper-Based Information  Coordinate decisions on key information –Determine information and documents that need to be entered into system  Establish process for data entry –How information will be entered into the system  Determine process for handling new outside documents  Allocate appropriate resources –Hardware and staff levels should align with information input volume

8. 8 System Performance  Evaluate hardware –Ensure minimum requirements  Load test system –Evaluate effect of typical number of users  Evaluate network capabilities –Test network to determine how it handles increased traffic and utilization  Implement system maintenance procedures –Ensure that they are in place and working

9. 9 Contingency Planning  Ensure that disaster recovery plan is in place –Make sure the plan is practical and appropriate for your office –Conduct drills related to possible emergency scenarios  Test system restoration process –Verify ability to restore system from backups prior to go-live

10. 10 Implementation Approach  Gauge physician preferences –Determine amount physicians are willing to reduce productivity levels  Evaluate staff perceptions –Receptiveness to system, strength of project leadership  Develop rollout of system modules or functions –Based on desired productivity and receptiveness levels  Incorporate appropriate training into plan –Ensure amount of training matches implementation approach –Make this training “mandatory”

11. 11 Questions

12. Telephone: 502-454-5112 Fax: 502-454-5113 E-mail: tgeltmaker@hce.org

13. All material presented or referenced herein is intended for general informational purposes and is not intended to provide or replace the independent judgment of a qualified healthcare provider treating a particular patient. Ohio KePRO disclaims any representation or warranty with respect to any treatments or course of treatment based upon information provided. Publication No. 931300-OH-1256-6/2010. This material was prepared by Ohio KePRO, the Medicare Quality Improvement Organization for Ohio, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Ohio KePRO Rock Run Center, Suite 100 5700 Lombardo Center Drive Seven Hills, Ohio 44131 Tel: 1.800.385.5080 Fax 216.447.7925 www.ohiokepro.com