Six Must-know Tips to Implement an Effective EHR

Tip #4: Remember that communication is essential.
"It is difficult to make sure you keep the necessary players in the loop. As you prepare to move to an EHR, I think it is critical to create a leadership team that is made up of individuals who trust each other and who are ready to communicate the major steps along the way. You need players who are willing to share the good, the bad, and the ugly about the system. Then your team needs to be prepared to problem solve, remain positive, and look for ways to improve processes."
–Betty Lanzrath, MA, RHIA, director of HIM for Newton Medical Center in Newton, KS

"At our facility, we were fortunate enough to have a well-versed vendor lead us in our transition from paper to the EHR. The most advantageous action we took was to consult with every area in the hospital over the course of one week. During that week, we held a 'white board' session during, which a registered health information administrator (RHIA) from the vendor led each department in a discussion of how employees currently accessed the record and how that would change with the EHR.

"The RHIA also conducted a small educational session on how the EHR functioned and pointed out some of the benefits (i.e., more than one person could access information at the same time, workflow or work lists could be triggered off of a document type or admit type, and the current record would be available before discharge).

"This process gave utilization review, coding, nursing managers, clinical and ancillary managers, administration, and physicians a chance to see both current and future benefits of the EHR. It gave our facility buy-in and identified all of our process, policy, and procedure changes up-front so that we would not have to scramble after go-live. The transition was much smoother. At first, the idea of white board sessions seemed to be rather burdensome, but it ended up streamlining and driving all of our workflow at our facility."
–Dawn Osborn, MHS, RHIA, MT, business office IT manager for St. Bernards Medical Center in Jonesboro, AR

Tip #5: Recognize that paper will never disappear completely.
"For some hospitals, scanning will continue to be a permanent or phased portion of the implementation of an EHR. It may be part of downtime procedures when clinicians and other caregivers must use paper. If the clinician/caregiver does not re-enter the information into the EHR, the forms are scanned. Some hospitals may also scan correspondence and records from other hospitals to include in their own permanent record."
–Elaine Lips, RHIA, president and CEO of ELIPSe, Inc. in Los Angeles

Tip #6: Keep usability in mind.
"Effective implementation requires ease of use. All the bells and whistles won't mean much if the users find the system confusing, frustrating, limiting, and slow. Therefore, for implementation to be successful, the end user must be involved in assessing each system's usability during the selection process, including such factors as:

• Logging on and off


• Screen design and information displays and controls


• Navigating within a screen and between screens


• Entering, accessing, and transmitting data


• Integrating with practice managements systems and e-prescribing systems


• Automating the coding process and accuracy


• Connecting with payers, labs, patient portals, etc.


• Assessing functionality of decision support, guidelines, disease management, and other resources


• System user requirements and user options


• System feedback


• System responsiveness


• System speed regarding various functions and user interfaces

"The more intuitive, the better. It's not just what the system can do, but also how it performs each task and how long it takes. Providers must consider these factors if the adoption is to be effective."
–Claudia Tessier, RHIA, president of mHealth Initiative, Inc. in Boston