Health Care Education & Training

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1 AVOID EHR PROBLEMS Health Care Education and Training Webinar Presented by Ron Sterling 1000 Kersey Road Silver Spring, MD Disclosures & Disclaimers Ron Sterling states he does not have a financial relationship with any Commercial Interest Organization as defined by the American Nurses Credentialing Center (ANCC). Ron Sterling is President of Sterling Solutions, LTD, and author of book Keys to EMR/EHR Success. As stated in the No Conflict of Interest policy maintained by Health Care Education and Training, Ron Sterling agrees to present the following information fairly and without bias. Any views or opinions in this presentation are solely those of the presenter and do not necessarily represent those of the funders. Health Care Education and Training, Inc. accepts no liability for the content of the presentation or for the consequences of any actions taken on the basis of the information provided. Please complete the Sign-in in and Evaluation forms. Fax to HCET at (317) Access our archives at Need Assistance? Health Care Education & Training Webex Technical Support Click the tabs at the top of your toolbar to adjust which panels you can see. Use the CHAT feature to submit your questions or comments at any time. Your chat history will appear here. Enter your question here and hit send Toggle between full-screen mode (slides only) and split-screen mode (slides and toolbar) 5 6 1

2 RONALD B. STERLING, CPA Ron is a nationally recognized thought leader on the selection and implementation of Electronic health record and practice management systems. He has advised healthcare organizations and practices across the country and has analyzed software from over 150 vendors. Ron publishes the popular EHR Blog, Avoid-EHR- Disasters.com and he authored Keys to EMR/HER Success winner of the 2008 Book of the Year Award by the Healthcare Information and Management Systems Society (HIMSS). He also hosts The EHR Zone on HealthcareNOWRadio.com and has contributed articles to a wide range of publications including the widely used Marketing Your Clinical Practice. What Is An EHR Problem? Inappropriate Products Continuing Use of Paper Records Never Used EHRs Makes Problems Worst Partially Used/Implemented EHR Inconsistently Used EHR Multiple Solutions/Processes Use of More than One EHR EHRs with Unreliable Information 7 INITIAL CAUTIONS!! Bet the Practice proposition. Affects every doctor, NP, nurse, staff member, and patient. Costs more money and consumes more resources than just about anything else. Mistakes will cost your practice more than money. Failure will strategically damage the practice. EHRs Pay For Themselves Unrealistic Hard and Soft Costs Minimizing Services Excluding Transition/Internal t Expenses Improbable Cost Savings Assuming 100% Usage Immediately Expecting Immediate Cost Savings Ignoring Continuing/Upgrade Costs EHRs Pay For Themselves Recovery/Mitigation Strategies Create a Workable Budget Include Contingency Money Approve and Authorize Budget Evade Partial Implementations Reality Check on Timing Allocate Internal Resources Allow for Transition Time EHR Management Expecting the Vendor to Lead/Manage Lack of Top Management Involvement Lack of Authority/Mandate Poor Management Readiness No Practice Plan No Responsible Party Focusing on the Wrong Issues Lacking Practice Project Management Limited EHR Focus 2

3 EHR Management Mitigation/Recovery Strategies Articulate Objectives Empower the Project Support the Project/Process Assign Responsibilities Designate Project Manager Regular Management Meetings Regular Project Meetings Maintain a Formal Schedule Picking an EHR Product Lacks Relevant Clinical Content Basing Selection on Paper Charts Informal Selection and Review Subjective Analysis and Decision Assuming Another Practice s Solution Accepting PMS EHR Partner Cost Focused Selection Deciding to Build Own EHR Unrealistic Workarounds and Strategies Picking an EHR Product Understand Impact of an EHR Give All Participants a Voice Focus on Practice Issues and Needs Focus on Few Candidates Conduct Practice Focused Demo Get Answers to Questions Conduct Victory Tour Contracting To Buy an EHR Signing Vendor Contract as is Failing to Agree to the Business Terms Failing to Understand Business Terms Unclear Rights and Responsibilities Unbalanced Contract Terms Implementation Add Ons Split Contracts by Component Contracting To Buy an EHR Establish Business Terms/Purpose Examine Key Contract Issues Payment Termination Performance Warranty Support Review All Terms and Conditions Negotiate to Resolve Issues EHR Leaders and Champions Lack of Strategic Mandate Limited or No Clinical Standards No Clinical (Doctor/NP) Champions No Nursing Champions Delegated to Non-Clinical Staff 3

4 EHR Leaders and Champions Clinical Involvement Upfront Critical Mass of Physician/NP Champions Structure Clinical Verification Consider/Design Clinical Workflow More Than One Early Adopter EHR Leaders Must Invest Time EHR Leaders Must Be Champions EHR Setup and Customization Mimic Current (Paper) Operations Plan to Over Customize No Supporting Standards Individual Provider Focus Lack of Preparation for Setup Deferring Key Decisions Solving/Addressing the Same Issue More than Once EHR Setup and Customization Design Workflow Blueprint Consider Standards and Product Setup Analyze Setup Issues Before Starting Include Area Experts in Setup Effort Use a Formal Setup Process Deal with Interface Issues Establish One Solution to a Problem Formally Consider Changes Going Forward Training EHR Users Training Everyone on Everything Standard Vendor Training Limited Training Options No Practice Specific Materials Long Time Between Training and Use No Follow-Up Training Training EHR Users Training Sessions By User Type Multiple Training Options Practice Specific Materials Ample Practice Time for Users Assign and Use Super Users Tie Training to Use Go Forward Training Goals/Plan Transition to EHR No Adoption Stages No Adoption Options Every/No One Ready to Use EHR Facility Issues Have Not Been Considered Too Much Enthusiasm Lack of Transition Time and Plan Lack of Ready Support No Consideration of Paper Record 4

5 Transition to EHR Design Office Specific Transition Plans Plan Initial Support Require Users to Practice Ensure Front Line Support for All Users Formal Transition Plan and Goals Identify and Use Champions and Super Users EHR Deployment Lack of Key Staff and Doctor/NP Availability Lack of Schedule Lack of Awareness Lack of Enthusiasm Insufficient Preparation Insufficient Training Unresolved Problems with Efforts to Date EHR Deployment Set Goals and Schedule Post Deployment Training Post Deployment Support Use Champions to Expand Use Prepare to Support Spill Over Effects Over Support New Users Preserve Training and Implementation Efforts Monthly Meetings QUESTIONS AND ANSWERS RONALD B. STERLING, CPA BLOG: Avoid-EHR EHR-Disasters.com Office: (301) Please complete the Sign-in in and Evaluation forms. Fax to HCET at (317) Access our archives at