A Guide to a Stress-Free EHR Implementation
November 30, 2017
“How’s work going?”
“Stressful. We’re in the middle of an implementation.”
This conversation happens too often. EHR implementations are typically time-consuming with inflexible project plans that demand adherence to foreign workflows. Not-too-surprisingly, EHR sales teams tend to keep this customer experience close to the chest, and are highly hesitant to share details of the implementation experience.
It’s time to open the implementation curtain and empower your organization. We compiled questions to ask EHR vendors to clarify whether they will be a good partner in your implementation or just another headache, tips for building your internal implementation project team, and tools to practice open communication in order to limit surprises at go-live.
We spoke to Kelli Paull, Valant’s VP of Customer Experience, to get a better understanding of some important (and often overlooked) steps in implementation, and what organizations can do to ensure a smooth go-live process.
Step 1: Ask the Right Questions
Once you’ve narrowed down final EHR candidates, your implementation experience and the post go-live support team is likely to make a difference in your decision.
We suggest asking to see a sample of the EHR vendor’s implementation plan. The plan should have a standardized set of milestones, deliverables, and deadlines to ensure a timely go-live schedule. It should also be something your key stakeholders are comfortable with.
When looking at the implementation plan, here are a few things to look for:
1. Does the company get to know your organization and how you operate?
If your EHR doesn’t take the time to get to know your business operations and culture, they’re going to have a tough time getting you to use the EHR efficiently and in accordance with your organization’s goals.
Too many times, this lack of knowledge needlessly elongates the implementation process. If your EHR implementation team walks into a kickoff meeting asking questions that can be answered by visiting your website or speaking to your sales rep, they’re starting on the wrong foot.
How Valant Does it: The Valant team has four major steps to complete in our implementation process before the kickoff meeting. This may sound like a heavy lift before anything happens, but that’s exactly the point: we want as much work to be done as efficiently as possible to make the face to face meeting as productive as possible. Before the kickoff meeting, our team will:
- Hold an introductory call where our implementation team sets expectations and defines milestones for the process.
- Give your organization immediate access to a “sandbox” account within our Platform, along with a roadmap of upcoming product releases. We do this for a two reasons: we want our customers to get used to the interface well before go-live, and we want you to have the feature release roadmap for the sake of accountability and trust.
- Send your team a survey to better understand the features you require for go-live. The results of this survey will determine your estimated go-live date.
- Give access to an online customer portal where you efficiently help us learn about your organization including programs and services, funding sources, team goals, and much more. This information is gathered using software, making it easier on your team and leaving little room for error or for information to get “lost in translation” between your team and ours.
After these info-gathering steps, our project team is able to arrive at the kickoff meeting on the same wavelength as your team, acting as an extension of your organization with full knowledge of your operations as well as your culture.
2. How do they handle ongoing federal, state, and local changes to reporting requirements?
The paradox, “the only constant is change” holds especially true when it comes to behavioral health reporting requirements. Because reporting requirements may change at the national, state, or county level, your EHR must be diligent with all reporting requirements and have a proven plan for releasing changes to your reporting and/or workflow.
How Valant Does it: The Customer Experience team at Valant is intentionally structured to maximize local expertise. Each region has a Valant Solutions Analyst; that is an expert in regional reporting, including county and state levels.
The localized Solutions Analyst working with your organization understands all of the data requirements, at the most detailed level, to ensure that your organization is compliant and getting paid. This regional data is translated into efficient workflows that save time and money for your organization.
3. How does the project team measure success in the implementation process?
Each project needs a measurement of success, and an implementation is no exception. The measurement of success should be representative of how well the software is integrated into your staff’s daily habits and how positive your relationship is with your vendor on a continuous basis. How long does implementation take? What is your vendor’s approach to training? How many materials do they provide?
How Valant Does it: Valant has three basic measurements to determine a successful implementation. They are as follows:
- NPS: Net Promoter Score translates into overall satisfaction of a company. We send an NPS survey to every customer the day they go live to assess overall satisfaction of the implementation. Basically, the question is asked: “How likely are you to recommend Valant to a friend?” Valant constantly strives for high marks in response to this question.
- Adoption rate: This is the percentage of potential users who use our EHR to satisfaction. Our implementation team ensures adoption by providing in-depth training materials and the type of training that works best for each team; be it in-person or online. Our weekly check-in calls help us assess where each team may need more support, and detect it before the need may even be known.
- Total Cost of Ownership: This in-depth analysis helps organizations determine a financial estimate of the direct and indirect costs of the EHR. An example of a direct cost might be the annual fee for licensing the EHR software. An example of an indirect cost might be the time it takes to successfully and accurately complete certain workflows. This analysis should be done prior to implementing Valant so that you have a clear picture of how your financial health has improved post go-live.
The combination of these three measurements very clearly tell us (and our customers) how successful the implementation process was, and the result was of our initial partnership with each organization.
4. What will happen to your data?
When data is standardized going in, it’s going to be standardized coming out, ultimately producing reliable reports for government entities and other payers, your executive team, and your board of directors. Having a better pulse on overall business performance also means that your employees will have a much clearer understanding of how they’re doing, and perhaps identify areas for improvement.
But the question of data migration inherently brings up more questions: What is the health of the data in your existing EHR? Should you use the implementation project as an opportunity to start fresh? If you don’t migrate data, you’re not migrating bad habits and dirty data. If you do migrate data, the burden on end users will be lessened.
When you do go down the line of migrating legacy data into your EHR, you have to be realistic about it. What data is valuable? What data is not valuable? If you do migrate your data, do you have the opportunity to see, interact with, and approve of the data migration before go-live?
How Valant Does it: It’s important to identify the most important data to migrate. Valant prioritizes migrating the following data points:
- Basic demographic data that’s expected: first name, last name, date of birth, etc..
- Custom demographics that help you meet state or county data requirements.
- Clinical data: diagnoses, providers, programs.
- Billing data such as insurance or payers: primary, secondary, tertiary.
- Beginning balances for patients, so at the point that the migration is over, you’ll be able to see if there is an outstanding balance.
Our team also has a variety of tools that allow customers to scan and upload any data that is in PDF or some other electronic format that’s not in the EHR. Information such as notes, informed consents, or the release of informations can thus be accounted for.
Step 2: Build Your Project Team
After you’ve gone through all the questions you need to clarify which EHR will fully support you through implementation, it’s time to begin internal preparations.
An implementation takes time, prioritization, and balancing multiple project deliverables against daily responsibilities. When choosing your internal project team, identify employees who are movers and shakers within the organization. We recommend asking yourself these questions:
1. Who is motivating, forward thinking, a leader, and well organized?
If there’s a project team that isn’t motivated, doesn’t support the goals and objectives, and doesn’t understand the power of a new EHR, they’re going to stay stuck in old habits. You run the risk of using the new EHR to recreate the old EHR. On the other hand, if you have a team that’s motivated, the idea of changing processes or changing policies is exciting! It’s something that they want to do, and it’s something that they want to use to advance your organization.
2. Who is ready and willing to answer the tough questions, be challenged, and challenge?
Your team needs to be able to take charge in a way that’s motivating and encouraging for other employees. As they’re working through early milestones and deliverables of the project, can they tell the clinician or front desk that an hour or two in a given week is going to benefit them in the long run?
To ensure the project team is in alignment with the mission of the organization, and understands how the EHR helps fulfill the mission, you’ll want to empower this team with the resources they need to energize future end users by being able to answer the inevitable questions:
- Why are we implementing a new product?
- How it will improve my day to day and advance the organization?
3. Who is tech-savvy?
The only other component is that they need to be interested in technology and be tech savvy. Granted, “tech savvy” is based on a continuum. In this case, we mean someone who knows the value of technology and the benefits it can bring to each team and is motivated to organize learning groups to move forward.
A tech-savvy team member understands how you’re tracking data currently, where there’s value in your operations, and where value could improve. They should be able to evaluate the data that has been migrated— first to make sure it’s correct and in the right spot, but also simply to make sure it’s all there.
Step 3: Practice Open Communication
It is important to establish professional, open lines of communication with your vendor’s project manager. Expect your EHR vendor to provide regular updates to let everybody on the project team know the progress being made, how it’s going to impact the user experience once they go live, and also be honest and realistic about any setbacks. If there have been pitfalls or challenges that the vendor team has faced, they need to let you know that those challenges exist, what the risks are, and what they’re doing to help mitigate those risks.
Don’t forget that your EHR touches all aspects of your business. Your internal communication is just as important. Appoint a member of the team to keep your staff up to date and provide clear communication to end users throughout the project. This will pique interest and hopefully increase investment in the overall goal.
1. If you see something, say something.
Whether it is a weekly check-in, conference call, or training, you will have the full attention of your vendor’s project manager. This person is solely focused on your business, your team and making sure that you’re successful in the EHR, so take advantage of that resource!
Prepare for meetings ahead of time by coming up with the questions that you know you want to ask. If you don’t understand something, carve out 20 minutes at the end of the meeting to dig into the product and talk about how it will work for your team.
2. Take time for retrospectives
Retrospectives are a critical aspect of any project. After each project milestone, take 30 minutes to ask yourself these simple questions:
- Did the project team meet all required deliverables?
- Were some missed?
- If so, why?
- What can you do to correct it moving forward?
- Do future timelines need to be adjusted?
- Do you need to pull additional resources onto the project?
3. Continue communication post go-live
In addition to your EHR’s customer support team, your internal project team is a long-term, post go-live resource. Think of them as an extension of your vendor’s customer support team—one that is immediately available when you’re most vulnerable. All questions post go-live should flow through this resource to ensure workflows are being properly followed, the project’s mission and objectives are being met, etc.
This team should work with your EHR vendor to create and be responsible for updated Standard Operating Procedures (SOPs) and other critical documentation as your team evolves alongside the EHR. Also, don’t forget to equip them with the time and resources to train new employees. Doing so will help ensure long term success: standardization across end users, accurate data, clear roles/responsibilities.
From pre-contract signing to post-implementation, we hope you’ve picked up some pointers in getting your organization and your EHR vendor on the same page now and moving forward. If you’d like to speak to us about our implementation plan, request a demo below!