EHR software (Electronics Health Records) have become commonplace across hospitals and single physician practices alike. However, the process of creating and implementing an EHR system can be tedious and complicated. Conducting an EHR readiness assessment becomes essential prior to implementation to ensure that your practice is ready to support the new system. These assessments evaluate preparedness across each organizational component. 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 can render 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.
Considerations When Performing An Assessment
The readiness assessment phase of the EHR implementation process helps an organization determine whether it’s ready to make the switch from paper records to an electronic health records system. 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. With a thorough assessment, a practice can expect to hit the ground running with their new system, with every member of the team on board.
Basic requirements for readiness assessment in technical areas are:
- 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
- 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
- Availability of support systems and their automation
- How much data is entered manually
- How the customer is notified
Four Areas EHR Readiness Assessments Should Target:
- Organizational Culture
- Management and Leadership
- Operational Readiness
- Technical Readiness
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 EHR for adoption.
A few questions to help measure your readiness in this area:
- Are physicians active in both planning and decision making? This 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 would result 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 of the process 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 that are 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 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 implementation of the new system 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 patients been surveyed to determine how they will react when the new system is put into effect?
- Has anyone determined what kinds of vendor relationships will need to be developed 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 see large improvements in the quality of care and practice management efficiency. This phase also takes into account 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 should be done so that the standard of clinical efficiency after implementation of a new EHR system can be compared to the current EHR.
4. Care Management
Management should have a clear understanding of 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 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, the following questions should be answered before moving forward:
- How ready are the employees of the practice 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 of the physicians or other staff members have unaddressed questions or concerns regarding EHR?
2. Skills and Staffing Issues
The following questions should be answered 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?
- Also, have employee skill gaps been identified, and if so, have you determined how they will be addressed?
This part of the assessment evaluates the medical practice’s technical ecosystem and its 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 the EHR generated reports for patient population management, population and quality improvement been defined and documented? 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?
- Has EHR enabled e-prescribing, referral processes and others been designed and included 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?
- Have the IT staff been 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? Have the requirements included in the planning process?
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 that 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!