EHR Optimization: The New EHR Lifecycle

Congratulations – if you’re considering EHR optimization, that likely means you have a recent go-live behind you and now you’re looking forward to what’s next. Modern EHRs are significant investments that constantly change and require ongoing maintenance and improvement to realize value and benefits for patient care, satisfaction and hospital operations. How can your optimization efforts be strategic ones? Let's examine key ingredients for successful MEDITECH EHR optimization so your healthcare organization can be prepared for the transition and understand the components of this ongoing lifecycle.  

When to start optimization 

Optimizations are typically most successful when they are started one to two months post Go-LIVE. Even if you are in the midst of an EHR implementation, it’s not too early to start making plans for optimization. Organizations often simply can’t fit everything into an implementation, really making optimization efforts something to consider from the start. 

Regardless of the type of optimization you are planning for, it is important to give your users sufficient time to become familiar with the product as well as wind down from the grueling process of going LIVE with a new MEDITECH environment.  

Your new EHR offers capabilities that may spark ideas and clinicians may have a new lens to explore what’s possible and how that can improve workflows and patient care. This adjustment period is important in helping users realize what is needed instead of reacting to what was just different from their previous system.   

The population of data into the live system is another big factor into that adjustment period. Simply put, some things you can’t optimize until the data and/or workflows exist. After the first month or so of use, users will also be able to identify which workflows actually need to be evaluated for improvement versus functionality that may benefit from more education. Honing in on workflows that need to be improved will go far in yielding value in your optimization efforts. 

Where to begin with optimization 

Conduct a formal assessment of your MEDITECH environment as a first step in launching an optimization project. Review the system and workflows and gather feedback from everyday users within a formal process.  

Need help conducting this assessment? CereCore can help.

Here are some starting points for this process: 

• Start by rounding and talking to users about features they may not understand fully. Quick wins are often gained by showing users how to do something on the spot. 

• Interview users from various departments and roles and ask them about pain points – what's not working well? 

• Review dictionaries  

• Observe users to identify opportunities for streamlining workflows.  

• Document all pain points and optimization opportunities and set a time to prioritize them.  

• Looking at all MEDITECH modules you have contracted for is also a key step in this process. When reviewing your list of modules, it is crucial to determine what modules are being underutilized or possibly not utilized at all.  

• Identify if your healthcare system is not utilizing MEDITECH Best Practices where they are available.  

• Collect your findings into a concise document grouped by impact area such as patient safety, revenue, regulatory, user satisfaction, patient satisfaction, and so on. Organizing this information will also help you prioritize findings and determine next steps. 

Determine priority and define a strategic roadmap 

A thorough assessment of your EHR could produce optimization documents with a significant number of findings. Frankly, the results may be overwhelming to leaders and project team members. Don’t get discouraged—it’s natural for modern EHR implementations to need optimization. 

Prioritizing the assessment findings will require strategic decisions, but in the end, your organization should walk away with a roadmap that will guide optimization projects and future investments.  

For example, you may need to weigh the benefit of certain optimization items based on whether it could improve physician productivity or just make life easier for clinical staff. Or, it could make sense to prioritize an optimization that would generate revenue because a manual process wasn’t leading to consistent revenue capture. Patient safety or potential regulatory compliance items are usually high impact items to consider, too. 

During the assessment prioritization review, the leadership team could decide to attack all high priority findings or those identified as “low-hanging fruit” as a way to make quick progress. It is often beneficial to break down the level of effort by service line or department to prevent putting too much strain on areas of your healthcare system. 

Finally, be prepared to have conversations with your board and key stakeholders about the additional investment (time and money) that will be needed to move forward with optimization efforts. The strategic roadmap that results from the EHR assessment and optimization prioritization session will depict that value that can be realized by providers, clinicians and staff with consistent fine-tuning and maintenance of the EHR. 

Kickoff optimization projects 

Once you have tackled your optimization roadmap, it’s time to kick off the optimization phase of your EHR journey. Here are a few things to help you make your optimizations a reality: 

• Assign specific staff to the optimization project. The optimization phase should be treated like any project would be so you should assign a project manager to oversee the process.  

• Develop a clear project timeline. The project manager should set important milestones and outline Go-Live dates for new functionality in departments.  

• Communicate with staff about the optimization project and hold a kick-off. 

• Establish communication and project meeting cadences that make sense for those involved. Maintain a a project plan to keep everyone on track.  

• Determine if any of the optimizations or new functionality being implemented will require end-user education and develop a training plan.  

Final questions to consider 

Our team has assisted health care organizations of all sizes with their optimization efforts. So let me pose a few final questions to you as you consider the idea that optimization is just part of the ongoing lifecycle of having a modern EHR. 

• Staff burnout from initial implementation. What if you turned to a partner like CereCore so that you could save your staff from burnout? Which department is ready to begin optimizing first—maybe because they need it most or because they are the most passionate? 
  

• Conflicting hospital department initiatives. Is there a way to collaborate more? Would optimization support the initiative in any way? Would having someone from the outside with an objective point of view help leaders and IT teams with strategic plans? 

• Available resources / resources that show interest. Are there different resources you should enlist for optimization efforts versus those you relied upon heavily during the implementation? If you are lacking resources, consider the deep expertise that CereCore has to offer. 

• Budget. What conversations do you need to have with your board of directors, senior leadership teams or stakeholders so they understand the investment and the value of optimizing your EHR? If you connected the impact of EHR technology to the healthcare organizations broader goals, would that pave the way for future discussions around funding and budget requests? How could CereCore help you navigate those discussions? We have consulted with dozens of organizations recently and helped them present EHR optimization plans to their boards. 

• Utilization reports should be evaluated. What processes should be put in place so that utilization reports are reviewed on a regular basis to help inform ongoing optimization efforts? 

• Toolkit needs or alignment with organizational initiatives. Are there areas where greater collaboration among departments or clinical leaders is needed? 

• Upcoming regulatory changes. Could it be a strategic lever for your health system if you turned to an IT outsourcing partner to help with regulatory compliance? 

• Planned MEDITECH Updates. Could your health system get more out of MEDITECH if you had help maintaining it? 

• What MEDITECH functionality was not implemented during initial implementation? 

Bottom Line: Keys to Success 

• Treat the optimization phase as a project just like you did the initial implementation 

• Conduct an assessment or have an assessment of your current LIVE system completed for you 

• Identify wants versus needs 

• Assign a project manager 

• Designate specific resources to work on optimization 

• Identify specific milestones within the project plan to help set expectations 

• Identify success metrics up front so you can prove the value of optimizing your EHR 

More resources on optimization

• MEDITECH Rules: How to Start Optimizing and Solving Pain Points
• MEDITECH Expanse Registration Worklists: A Quick Win for EHR Optimization and Revenue Cycle
• Podcast: Why EHR Optimization Is Worth the Effort and Budget
• Podcast: EHR Optimization: How to Keep Improving After Go Live
• Revenue Cycle Optimization Assessment – Maximize Financial Performance Despite Increased Denials