EHR software (electronic health records) is commonplace across hospitals and single physician practices alike. However, creating and implementing an EHR system can be tedious and complicated. Conducting an EHR readiness assessment is essential prior to implementation to ensure that your practice is ready to support the new system.
These assessments evaluate preparedness across each organizational component.
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Regardless of whether you are a private practice or a group of hospitals, skipping this step may not only end up wasting untold amounts of time and money, but you may also not qualify for EHR incentive programs. EHRs provide numerous benefits, but a rushed or incomplete assessment renders many of them useless.
Understanding the basics of conducting an effective EHR readiness assessment is vital to lay the groundwork for the long-term success of your practice.
Table of Contents
- What Is an EHR Readiness Assessment
- Prepare for an EHR Implementation
- Five Major EHR Adoption Barriers
- Getting Started: Focus on Technical Areas
- Areas of Assessment
- Next Steps
- Final Thoughts
What Is an EHR Readiness Assessment?
An EHR readiness assessment is a phase of the EHR implementation process that helps organizations determine whether they’re ready to switch from paper records to an electronic health records system for the first time. As practices evolve and scale, their current EHR system may not be able to handle the patient data load. At this point, it’s a good idea to conduct an EHR optimization.
The process involves investigating and assessing various aspects of an organization to identify potential problems and address them before implementation starts. This way, a practice can not only ensure a smooth integration but may also avoid being forced to make major changes or corrections after implementation.
EHR implementation is a costly affair. For a multi-physician facility, implementation alone could cost $162,000, with an annual maintenance cost of $85,000, while hospitals may spend between $5 and $20 million.
An improper EHR implementation can result in reduced productivity and patients not getting proper care. Many end-user issues are avoidable by conducting an EHR readiness assessment.
With a thorough assessment, a practice can expect to hit the ground running with its new system, with every member of the team on board.
Prepare for an EHR Implementation
When implementing an EHR, planning is important. Plan for and follow the steps below before implementing an EHR:
- Get in Touch With Your Local Extension Center: Regional extension centers have the resources and personnel to advise and guide you at every step of the EHR implementation.
- Avoid EHR Adoption Hurdles: Make sure your practice covers all of its bases and avoids the many hurdles of EHR implementation listed below.
- Plan Your Workflow: Before choosing a new EHR, you should plan for how patients and their data move through your organization. You must design this workflow before you choose software. It’s important that you look at the way patients flow from one desk to the next to enhance care quality and optimize efficiency.
- Approach With a Plan: Planning with a timeline in mind is a good idea before you select a software vendor. Record all the processes and identify the ones you should start, stop or sustain.
- Select a Vendor: When selecting a vendor, ensure that the developers certified their health modules by showing adherence to certification criteria recommended by ONC.
- Train Staff: Training clinicians and staff is a considerable chunk of the EHR implementation process. The Workforce Development Program provides training materials that are ONC recommended.
- Go Live: Use a go-live checklist before you release the software. At this stage, the first step is to discuss going live with your software provider. It’s important to engage staff leadership and hire more support staff to handle technical glitches.
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Challenges
After conducting the EHR readiness assessment and answering the crucial questions, you should know about the hurdles you’ll face when you implement an EHR.
- Cost of Implementation: EHR implementation is expensive. Software costs aren’t the only resource drain to consider. Other sizable costs are staff training, hardware installation, maintenance and network fees. Unplanned expenses also crop up. Evaluating your financial resources is a very important step.
- Staff Resistance: Adopting a new EHR often isn’t a welcome change for staff. Additionally, the documentation process can be tedious without digital integration. Oftentimes, staff doesn’t stay updated about the technological advancements in the field, which can result in EHR implementation delays.
- Time-consuming Training: Staff will need training after you buy the software and before it goes live. The physicians and support staff have to put in the effort and spend time to understand and use the new system. The new workflow requires training and practice, which has to happen on top of maintaining patient loads.
- Usability: Usability is the most important factor after cost. Certain solutions may not cater to all types of specialties and may even hinder certain departments. A cardiologist may require different features compared to a psychologist, and the lack of personalized needs can have an effect on patient health, which can’t be taken lightly.
- Data Migration and Privacy: Data privacy is a constant concern in healthcare circles. Despite the imposition of a national policy to protect health data, data leakage happens due to cyber security failures and natural disasters.
Legal hassles and multi-million dollar settlements are common when data leaks happen, especially during data migration.
Now that you know about the top barriers to EHR adoption, the next stage is to prepare by conducting an EHR readiness assessment.
Focus on Technical Areas
The assessment must check the following:
Architecture
- Layered structure of communication, portal availability and operating systems.
- Service orientation, which is measurable through the services supported by the IT department, automated services and infrastructure service.
Infrastructure
- Hardware and software: desktops per employee and their operating systems, server and mainframe availability.
- How the system shares data externally.
- How it connects internally between departments in different locations.
Process
- Availability of support systems and their automation.
- How much data is entered manually.
- How the customer is notified.
Areas of Assessment
On average, most practices spend only nine weeks before finalizing an EHR, which may not be enough for an EHR readiness assessment’s multi-step multi-stakeholder evaluation process. Focusing on the following areas can help produce a thorough result.
The four areas EHR readiness assessments should target are:
- Organizational Culture
- Management and Leadership
- Operational Readiness
- Technical Readiness
Organizational Culture
This assessment phase evaluates the overall perception of an EHR within the organization, including the opinions of physicians, patients and staff. This phase seeks to gauge whether the EHR is viewed as something that would improve care, delivery and access. This stage also determines the members of the team who are willing to collaborate on finding and implementing an EHR system.
Organizational assessments evaluate procedures for patient-EHR interaction and suggest edits and corrections to patient information. It also involves an understanding of project plan development on four parameters: timeline, accountability, dependencies and assigning EHR deployment tasks.
This interaction provides a better understanding of the organization’s infrastructure and guides planning for EHR adoption.
Here are a few questions to help measure your readiness in this area:
- Are physicians active in both planning and decision-making? This question helps determine whether clinical and managerial interests are aligned.
- Has the framework for outlining EHR priorities been documented before starting the vendor evaluation process, and is it being used to facilitate decision-making?
- Does leadership understand the advantages of an EHR and have a clear and reliable vision for how it will support efficiency and quality improvement goals?
- Are the EHR champions able to devote sufficient time to planning for EHR adoption and implementation with efficiency issues in mind?
- Has IT’s strategic planning been an integral part of the practice’s planning process? This aspect results in a clearly defined plan that steers the EHR procurement process.
- Have quality and efficiency issues been documented as key objectives with measurable objectives and corresponding timelines?
Management and Leadership
This phase assesses the organization’s readiness to manage human resources for present and future requirements. From the management’s side, this stage requires process development and management focus. This stage has four components:
1. Financial and Business Issues
During the assessment phase, you should determine whether or not accommodations have been made for the new system in your organization’s current and future budget. Your organization should also retain an experienced healthcare attorney to assist with contract negotiations. Here are a few more things to consider during this step of the assessment:
- Have any protocols been implemented to minimize the costs associated with making the switch?
- Has a cost-benefit analysis been performed?
- Has return on investment (ROI) analysis been estimated and accounted for?
- Will funds for the ongoing adoption of required standards and upgrades be a part of the general budget?
- Has acceptable productivity loss and temporary reductions in revenue been estimated and accounted for?
2. Strategic Issues
The new system’s implementation will involve ongoing costs for the protection, enhancement and support of data that’s used by the practice. Keep the following points in mind:
- Have you determined which employees will assume leadership roles during the implementation process?
- Has the organization examined which benefits it will enjoy by switching to an EHR system?
- Have you surveyed patients to determine how they will react when the new system is put into effect?
- Has anyone determined what kinds of vendor relationships need development to make this happen?
- Have any specific plans regarding the exchanging and sharing of health information been made?
3. Quality Improvement
It’s important to know if implementing a new EHR will improve the quality of care and practice management efficiency. This phase also accounts for any strategic plans you might have in place. Additionally, this step ensures that there is a plan in place to measure the boost in clinical efficiency. This measurement helps compare the efficiency of your new vs. old EHR.
4. Care Management
Management should understand how care management will benefit the practice or area of focus. You should identify your clinical practice champion as soon as possible to help smooth out any implementation wrinkles. Staff also needs to be assigned to the quality improvement and quality assurance process.
Operational Readiness
Operational readiness includes EHR policies and protocols, managing vendor relationships, staffing requirements and training for project managers and other personnel involved in EHR integration. Organizational readiness in this area will highlight potential barriers to EHR integration so that changes can be made accordingly. There are two aspects to this phase:
1. Training Issues
Concerning training issues, answer the following questions before moving forward:
- How ready are employees to learn how to use this new technology?
- Is the staff fairly tech-savvy, or will a steep learning curve be involved?
- Are there specific individuals who could be put in charge of technical assistance for those still learning to use the new system?
- Do most employees routinely use computers at the practice?
- Do any physicians or other staff members have unaddressed questions or concerns regarding EHR?
2. Skills and Staffing Issues
Answer the following questions about skills and staffing issues:
- Does your practice have access to professionals who possess impeccable IT skills?
- If you don’t already have someone on staff who is well-versed in this department, are you prepared to outsource the work to ensure a smooth implementation of the EHR system?
- Will coding and compliance professionals be available to assist during the process?
- Have you identified employee skill gaps, and if so, have you determined how to address them?
Technical Readiness
This part of the assessment evaluates the medical practice’s technical ecosystem and IT capabilities. Technical assessments analyze existing technology, staffing for EHR implementation and infrastructure issues.
The following questions.
- Which of the practice’s existing computer systems will interface with the new EHR system?
- Has an inventory of your practice’s hardware been performed to ensure that you have everything you need?
- Have you defined and documented the EHR-generated reports for patient population management, population and quality improvement? Have the requirements been included in the planning process?
- Is the patient interaction with EHR determined by patient input? Have their requirements been included in the planning process?
- Have the policies and procedures for corrections or amendments to patient records and release of information been analyzed and discussed? Is a plan in place to develop communications for patients and other external organizations?
- Have you included EHR-enabled e-prescribing and referral processes in the planning process?
- Does the IT management team have experience in data integration, conversion and system integration? If not, does the practice have the resources to fill the internal skill and knowledge gaps?
- Are IT staff educated about EHR objectives? Keeping them informed helps them engage in the EHR decision-making process to determine infrastructure requirements.
- Has the practice performed a needs assessment of hardware, desktops and other devices to support EHR? Are these requirements included in the planning process?
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Next Steps
Once you conduct a thorough assessment, you may want to address the training gaps for administrative staff and physicians by implementing EHR software or customizing the suite to the practice’s needs.
Transferring patient and administrative data from paper-based records to EHR software may also involve allocating and training the staff to complete data entry. Identifying your requirements is a critical step in the process. Quite often, physicians are overlooked when asking for feedback.
Final Thoughts
Today, technology has changed every area of work and life. Data should be documented, integrated with other systems, and retrieved and examined for better care and higher profits. As tempting as it might be to skip the readiness assessment phase, doing so is a surefire way to end up choosing the wrong EHR.
Even if you think you know some of the answers to the questions above, you should still methodically address them during the assessment. All relevant team members should be included in the process as well because their insights may differ from yours.
It may take time and effort, but after successful implementation, you’ll likely qualify for EHR incentive programs, and with that extra cash flowing into your business, you’ll be glad you performed an EHR readiness assessment.
Have you conducted an EHR readiness assessment recently? If so, tell us about any tips or challenges you faced doing so in the comments below!