5 steps to prepare for an EHR switch

A clearly defined business case for is the first requirement for an making an EHR switch. Once that has been approved, there are five steps for the organization to follow to prepare for the switch.

Once the decision to make an EHR switch is made, define the desired scope, timeline, budget, and resource model for the implementation.

Governance is a critical aspect of preparation. Establishing an efficient and uncompromised governance structure ensures that key decisions are made by the right people. Incentives should be aligned to ensure that all stakeholders are motivated to achieve the implementation milestones. Health systems should dedicate adequate staff and time to the EHR implementation, as the process requires significant resources and attention.

In addition, health systems should establish clear decision-making processes and timelines for resolving debates and discussions. This includes addressing potential disruptions in clinician compensation and ensuring that the right resources are available at the right time.

An effective governance model engages the right stakeholders to help shape decisions in each of the relevant areas — clinical, revenue-cycle, operations, infrastructure — and ensures that those stakeholders have enough influence to enforce the implementation of these decisions.

Working with an external partner, like Optum Advisory,¹ during the planning phase can add tremendous value to planning an EHR switch. An external partner can provide neutral observations and insights, especially in situations that fall outside the standard EHR playbook, such as accelerated timelines or major transformations.

By leveraging the experience of an external partner, who has helped organizations through many different EHR implementations, health systems can mitigate potential challenges and ensure a smooth transition.

Engaging with an established implementation partner also benefits health systems by:

• Accelerating the transition timeline
• Improving the predictability of the implementation outcomes (and success)
• Expanding and flexing capacity to work around unexpected events
• Augmenting the EHR vendor’s playbook with incremental capabilities related to clinical and digital transformation

Clinician adoption and change management are crucial for the success of an EHR switch. Clinician change management ensures that clinicians are on board with the switch, minimizes disruptions, improves adoptions rates, and improves clinician satisfaction.

For clinician change management to be effective, there are a handful of strategies to consider:

Data conversion is a common challenge during an EHR switch. Health systems must determine the minimum data that needs to be transferred to the new system and ensure that historical information remains accessible. Overloading the system with unnecessary data can lead to delays and increased costs.

Aligned incentives and clear expectations can help mitigate resistance from staff and encourage them to engage with the data conversion process and contribute to its success. For example, offering bonuses or additional time off for staff who meet specific data conversion milestones can motivate them to prioritize tasks related to the EHR switch. Similarly, recognizing the efforts of staff through awards or public acknowledgement can boost morale and foster a sense of ownership and commitment to the project.

In addition, there are several new AI-enabled tools to help health systems do data conversion better and faster, different from what they may have done in previous EHR implementations.

4 common challenges to EHR switches

EHR switches can be difficult. Prepare for possible challenges, including the four detailed below.

One of the primary challenges during an EHR switch is managing the workflow disruption caused by the transition. Health systems must carefully balance the involvement of staff in the implementation process with their regular responsibilities. This often involves reallocating people away from their daily tasks and managing the impact on operations and finances.

Some EHRs have requirements on the number of people needed and the type of resources that must be in place at certain points in the implementation. If the right people are not brought in at the right time, the project timeline can experience major setbacks.

Inefficient governance and slow decision-making can lead to project delays and cost overruns. Therefore, establishing clear decision-making processes and timelines for resolving debates and discussions is crucial.

Disruptions in clinician compensation can lead to staff resistance and several challenges during the implementation. For example, clinicians could be worried if they think compensation could be negatively impacted by the EHR switch due to increased administrative responsibilities and reduction in clinic volumes during the go-live period. Changes in compensation can also disrupt clinicians' workflows if, for example, a new EHR system requires additional documentation, which would require clinicians to spend more time on these administrative tasks.

How to measure success with an EHR switch

After implementing an EHR switch, a health system must measure success and ensure that the transition has been executed correctly. There are three steps a health system should take.

During the EHR switch, health systems should track program-related metrics to provide a clear picture of the project's progress and help identify areas that require additional attention.

Specifically, health systems should monitor the following four key performance indicators (KPIs) during an EHR switch:

• On-time delivery: This indicator tracks whether the implementation milestones are being met according to the established timeline. By monitoring on-time delivery, a health system can address any delays promptly and ensure that the project stays on schedule.
• Budget adherence: This indicator tracks whether the implementation is being completed within the budget. Cost overruns can strain financial resources and impact other projects. Monitoring budget adherence helps ensure the implementation remains financially viable and allows for necessary adjustments to be made.
• Go-live readiness: This indicator assesses whether the health system is prepared to transition to the new EHR and includes evaluating the completion of training, data migration, system testing, and other critical activities.

After the EHR switch, health systems should focus on achieving the expected clinical, operational, and financial benefits. This involves setting benchmarks for revenue cycle performance, patient portal adoption rates, and clinician satisfaction.

A health system can use of EHR metadata to track various aspects of healthcare delivery like clinical outcomes, patient satisfaction, and operational efficiency. By leveraging this metadata, health systems can gain valuable insights into their performance and identify areas for improvement.