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


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

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

Elise Ames, MS, PMP Senior Project Manager
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
  • You need clear goals and realistic expectations

Understand the Project Phases
Initiating Steps
Commitment from your Team
  • Buy-in from all staff who will use or whose
    workflow will be affected by - the system is
  • 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

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
  • 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

Define the Scope
  • Project Scope Statement is a document delineating
    what is included in the project and what is not
  • 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

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!

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

Plan the Approach
  • In-house Server Environment
  • Remote Hosted or SaaS
  • Pros
  • Control of your data
  • Less reliance on Internet connection speed and
  • 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

Planning Steps
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.

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
  • 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?

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
  • of chart pulls
  • Number of phone calls from Pharmacies

Plan the Schedule
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
  • Communicate the schedule throughout the practice

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.

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
  • Update the work flows and communicate with staff

Executing Steps
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
  • Avoid the do it yourself (or using your
    nephew) approach to technology support

  • 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.

  • Different levels of training are offered
  • Larger groups will benefit from super user
  • 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.

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

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.

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

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

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
  • Work with your staff to understand their concerns
  • Communicate!