Post EHR Implementation Strategies

Just because your practice has survived the EHR go-live doesn’t mean that you’re in the clear. To fully reap the benefits, practices must continually evaluate their goals and needs, improve workflow, and leverage the analytics power inherent in the technology. This article provides several questions that practices must answer as they enter the post-implementation phase of the EHR transition approximately 3-4 weeks post-go-live.

EHR Implementation Related Questions

1. Did the practice meet its goals? If so, what new goals have emerged as a result of EHR implementation?

For example, now that the EHR is live, when will physicians begin to use computerized physician order entry? When will the practice incorporate the EHR into the exam room? If so, when? Will the practice launch a patient portal? If so, when and how?

When thinking about goals, consider this acronym: SMART, which denotes specific, measurable, attainable, relevant, and time bound. For example, the practice may want to use the EHR to improve breast cancer screening rates for at-risk patients. Therefore, a SMART goal would be to improve your screening rate by at least 20% in six months. Similar goals could include engaging a certain percentage of patients with the portal, achieving a certain collections rate, or screening for annual exams.

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2. Must the practice adjust or re-evaluate its workflow processes?

For example, can the practice customize templates to capture additional clinical information necessary to improve outcomes? Do any employees require additional training, or must you adjust staff roles and responsibilities? For example, some employees may not acclimate well to the electronic record. Can your vendor provide additional training for these individuals?

3. Is the practice capturing important quality-related data elements?

This includes data necessary for internal clinical purposes as well as reportable quality measures related to Meaningful Use, the Physician Quality Reporting System, and other programs? Work with your vendor to ensure that data elements are submitted correctly.

4. Is the practice using the EHR to actually improve the quality of care?

This requires using the EHR’s clinical decision support (CDS) functionality that includes the following:

• Computerized alerts and reminders based on patient-specific data (e.g., diagnosis, medication, gender, age, and lab test results)
• Clinical guidelines and established best practices
• Condition-specific order sets
• Focused patient data reports and summaries
• Documentation templates
• Diagnostic support

Regional Extension Center of New Hampshire, says her practice worked with an EHR vendor to generate custom reports that help the practice remind patients of annual physicals. Dr. Christopher Tashjian, a specialist in family medicine practicing in rural Ellsworth, Wisconsin, says his vendor implemented an after-visit summary feature to enable his practice to print visit summaries for patients.

5. Has the practice conducted a formal post-go-live evaluation?

HealthIT.gov provides several important questions during ask during this evaluation. These questions pertain to culture and adoption, network and infrastructure, and the EHR vendor. DOQ-IT University also provides a helpful post-go-live evaluation tool that includes a checklist with questions related to practice interaction with the EHR, billing, administrative tasks, e-prescribing, lab services, and more. Collecting this data in a formal way helps identify and resolve workarounds as well as other opportunities for improvement.