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Top 10 Enterprise Tips for Implementing an Effective EHR

by Ryan Champlin, VP for Operations, Cook Children’s Health System

Ryan Champlin is the vice president of operations for Cook Children’s Health Care System, an athenahealth client. Based in Fort Worth, Cook Children’s is a non-profit network with 393 pediatric providers and more than a thousand staff in 50 locations across Texas. For more information go to their website.

We brought more than a thousand providers live on athenahealth’s network in February, 2010 after a seven-month implementation. We now have 100% physician adoption. Our first year as a partner with athenahealth has taught both of us some valuable lessons that I’d like to share with the providers who are just behind us in moving to an effective electronic health record

Here’s my Top 10 list for success with a new EHR at the enterprise level:

1. Make patient care your goal and then clarify how the EHR project will make that goal achievable.  We’re focused on the ability to give each of our patients a lifetime medical record that will be accessible via the web. Since the effort is focused on patient care, the ability to bring frustrated physicians back to that cause helps everyone get through the tight spots.

2. Know your first go-live will generate the most energy and you will want to use that energy to build momentum. Plan your implementation to bring rainmakers live first and set up some friendly competition to see who can have the smoothest go-live. After all, physicians are a competitive bunch.

3. Use the flexibility of athenaClinicals to your advantage.  Short, more efficient templates—and being able to improve them on the fly—really impressed our providers.

4. Guard against being too flexible.  This is the old double-edged sword because the flexibility of athenaClinicals helped make it the KLAS number one choice for pediatrics. But if they build it too flexible, the record can get cluttered in an enterprise environment like ours.  Now that we are almost fully live, we are naming a team of physicians to go back through the record and streamline it.

5. Set clear expectations at the outset and broadcast them across the organization.  Our project leadership understood that we chose athenaClinicals because of its efficiency but this message was not conveyed very well throughout the organization.  This led some physicians to question “missing” functionality – the old “if we are going electronic, why do we have to do anything on paper?” discussion.

6. Create an executive steering committee to manage the politics of the project.

7. Use a project management consultant to keep the entire effort on track. 

8. Pick input devices early and let the providers get familiarized with them before the go-live.  We sometimes forget that most physicians are not very comfortable with laptops.

9. Build your wireless connectivity for speed.  Overnight, users can go from being amazed by a wireless connection to becoming frustrated with slow refreshes.

10. Start finding important things to send to physicians via email before the project kicks off.  We sent out a lot of project information via email before we found out that many of our physicians never checked their messages.  You need them to be in the habit of using email to communicate so that project news and updates can be conveyed effectively.

Remember that helping large organizations move to a better place is not easy and it can be very frustrating but it is worth the effort.  Also, remember that you have the ability to improve the life of every patient you care for with an athenahealth medical record. Unlike traditional EHRs, athena’s is evolutionary and keeps changing and improving to meet the needs of care.

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