Project Management Techniques to Keep your EHR Implementation on Track - PowerPoint PPT Presentation

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Project Management Techniques to Keep your EHR Implementation on Track

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Elise Ames, MS, PMP. Senior Project Manager. Project Management Basics. EHR implementation project success is more dependant on people and process than ... – PowerPoint PPT presentation

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Title: Project Management Techniques to Keep your EHR Implementation on Track


1
Project Management Techniques to Keep your EHR
Implementation on Track
  • VITL Summit
  • September 25, 2009

Elise Ames, MS, PMP Senior Project Manager
2
Project Management Basics
  • EHR implementation project success is more
    dependant on people and process than it is on
    software and hardware.
  • Successful EHR project management requires
    frequent, effective communication between all
    parties.
  • You need clear goals and realistic expectations

3
Understand the Project Phases
4
Initiating Steps
5
Commitment from your Team
  • Buy-in from all staff who will use or whose
    workflow will be affected by - the system is
    critical.
  • You will need a physician champion
  • You will need a project manager.
  • In small offices, typically the practice manager
  • Larger offices may require external help
  • You will need a technology partner especially
    if using an in house server model

6
How to Get Buy In
  • Involve the team in the selection process they
    should review functionality with an eye to what
    is important to them. Give everyone a voice and a
    vote.
  • Involve the team in the workflow redesign process
    they will understand how the system will affect
    their work and they will have the best ideas on
    process improvements

7
Define the Scope
  • Project Scope Statement is a document delineating
    what is included in the project and what is not
    included.
  • For example
  • Practice Management and EHR or EHR only
  • In-house servers or remotely hosted solution
  • Dictation vs. voice recognition vs. structured
    data entry with templates
  • ePrescribing
  • On-line eligibility checking
  • Drivers license scanning
  • Patient Portal

8
The Importance of Scope Definition
  • It helps you not overbuy or under buy.
  • It is the foundation of your schedule, budget and
    resource planning.
  • No surprises!

9
Plan the Approach
  • Practice Management and EHR
  • EHR Only
  • Pros
  • Integrated system
  • One database (depending on the product)
  • One vendor to manage
  • Cons
  • Longer timeframe to implement
  • Risk to A/R when changing billing systems
  • Requires more data conversion
  • Pros
  • Shorter implementation timeframe
  • Lower cost
  • Less risky than implementing a new billing system
  • Cons
  • Requires interface to/from existing PM system
  • Higher complexity
  • Multiple vendors to manage

10
Plan the Approach
  • In-house Server Environment
  • Remote Hosted or SaaS
  • Pros
  • Control of your data
  • Less reliance on Internet connection speed and
    availability
  • Cons
  • Higher upfront cost
  • On-site servers require care and feeding
    (backup, patches, configuration, disaster plan)
  • Pros
  • No server headaches
  • Predictable monthly cost
  • Cons
  • Pay forever and never own equipment
  • More reliance on Internet connection speed and
    reliability

11
Planning Steps
12
Solidify the Approach
  • Phased in or big bang?
  • All providers, all patients at once or gradually.
  • How will paper records be converted?
  • How much customization to forms, templates, etc
    will be included (Less customization is better)
  • What interfaces to external systems will be
    needed? For example, lab, registries, etc.

13
Understand the Vendors Methodology
  • Ask for a sample implementation work plan as an
    exhibit to your contract.
  • Services agreement should clearly state how many
    hours of training and implementation services are
    included
  • Should also specify how services are to be
    delivered for example webinar training, on site
    training, will they be on site to support you
    during go-live?

14
Define Goals and Measures of Success
  • Quantifiable goals clearly stated.
  • For example not go paperless but 95 of
    patient encounters will be electronically
    documented by all providers by March 1, 2010
  • Many potential measures
  • of prescriptions sent to the pharmacy
    electronically
  • of chart pulls
  • Number of phone calls from Pharmacies

15
Plan the Schedule
16
Plan the Schedule
  • Negotiate with the vendor do not be pushed into
    an implementation schedule that is too
    aggressive, or doesnt work with other events you
    have planned.
  • Get dates from the vendor in writing for items
    such as software delivery, training and go-live
    support.
  • Communicate the schedule throughout the practice

17
Plan the Budget
  • Understand how much the system will cost.
  • Not only the upfront costs, but also ongoing
    maintenance, subscriptions and other fees.
    (Dont forget travel costs often overlooked and
    can add up fast!)
  • Include additional staff costs for training and
    back loading data.
  • Plan for lost productivity due to provider time
    to get up to speed.
  • Add 10 contingency.

18
Redesign the Workflow
  • Document the existing workflow for key processes
    that will be affected by the system
  • Scheduling, check-in, eligibility, telephone
    encounters, patient communication, test ordering,
    prescription writing, report sign off, etc.
  • Review this workflow documentation with the
    vendor at training ask them to explain how the
    workflows will be changed once the system is
    implemented.
  • Update the work flows and communicate with staff

19
Executing Steps
20
Procure and Install Infrastructure
  • Working with a technology partner, buy and
    install IT infrastructure.
  • Wireless networks most common.
  • Get buy in from providers for end user device
    choices, tablets, laptops, etc.
  • Make sure network and infrastructure is tested
    and working before software delivery.
  • Have a plan in place for infrastructure failure.
  • Consider a support contract with your technology
    partner
  • Avoid the do it yourself (or using your
    nephew) approach to technology support

21
Customization
  • You will be inventorying existing chart forms,
    templates, flow sheets, etc. to determine what
    customization to the EHR will be needed.
  • Keep an open mind about using as many out of the
    box forms and templates as possible when going
    live especially for the first few months.
  • Specifically limit provider specific
    customization collaborate to develop practice
    wide standards.
  • Test all customization! Have providers agree
    that a template or flow sheet is working.

22
Training
  • Different levels of training are offered
  • Larger groups will benefit from super user
    training
  • Make sure you allocate enough time for users to
    practice using the system before live.
  • Consider one on one training for providers
  • Use pre-loading (of schedule and charts) to help
    users practice.
  • Consider user competency tests.

23
Data Load
  • Combination of document scanning and data entry
    of structured data.
  • Approach must be planned carefully to maximize
    productivity.
  • May need to backfill staff

24
Testing and Validation
  • Many systems do not have a test environment or
    want to charge more for a test environment
    forcing you to test in the live environment.
  • Before live, test each template, screen, function
    to make sure it functions as advertised in the
    user manual.

25
Go-Live Preparation
  • Dress rehearsal test work flow
  • After hours, provide food
  • Communicate with patients and staff
  • Assign specific staff to assist with the go-live.
    Document issues as they come up, prioritize and
    resolve.

26
Closing Steps
27
Turnover to Support
  • Understand the timeframe after live during which
    your vendor trainers will be available for
    questions.
  • Designate a person in your practice (not a
    provider) to be the liaison to the vendor support
    on an on-going basis.

28
What if Things Dont Go as Planned?
  • If the schedule slips, regroup and plan for a
    realistic timeframe.
  • Dont sacrifice quality to the schedule.
  • Pro-actively manage risks
  • Work with your vendor to escalate issues as
    needed.
  • Work with your staff to understand their concerns
  • Communicate!
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