Large implementations can be overwhelming, and often organizations run out of steam. Modern EHR platforms are like living, breathing entities that require care and feeding to keep an organization moving forward.
At some point after go-live, possibly months or even years later, IT leaders and teams will begin hearing complaints from users and organizations will demand more value and functionality from their EHR. The optimization phase that was shut down early or abandoned will need to be revitalized. To do so, you’ll need resources and budget. You’ll need to make a pitch to the CFO, maybe the hospital board. You'll need to prepare for conversations with other leaders in the organization who speak a very different language than IT.
How should a health IT leader start the conversation and begin preparing for EHR optimization? Is an EHR assessment the right place to begin and how can it help with the pitch for optimization? What can you expect to learn from an assessment? What strategies should you employ along the way to help encourage ongoing optimization?
These questions on the topic of EHR assessments and optimization were covered in an episode on The CereCore Podcast with host Phil Sobol, Vice President of Business Development, and a panel of EHR experts from CereCore:
Find conversation highlights below and stream the full episode.
Uncover opportunities for ROI with an assessment
Phil Sobol: Sometimes having an outside voice for an assessment is helpful, because you bring in a firm, and they've seen this 10 times, whereas your organization is experiencing it for the first time. Or you may think you've got a rock-solid plan, but you want a little bit of backup before you move forward with board-level approval. It could help you prove you’ve done your due diligence, and we've validated it with a third party.
From an assessment standpoint, we are trying to identify those areas in an EHR that might be underperforming. Often there are quick wins when it comes to things like charges that aren't being captured. In your experience, what are some trends in optimization? What are areas that everybody's looking at right now?
Bob Gronberg: If you are post-go live for an EHR implementation and end users are grumbling, it's prudent to bring in an outside perspective for an EHR assessment. Are you using the tools efficiently? Have your end users started to create bad habits or workarounds? Having that independent view that's devoid of emotion is a good first step.
We have worked with several organizations on assessments to document, categorize and prioritize things. Some have an immediate ROI, especially when it’s related to charging. Other items are about improving efficiencies and the way physicians and clinicians are using the tools.
If you can save a minute and calculate the number of physicians or clinicians who do that task, multiplied by the patients and the days, it can lead to significant savings quickly.
Stephanie Murray: Epic offers a slew of tools and recommendations for optimization. But often, you need to request budget for those types of things or additional resources. And how do you do that?
One thing that's helpful, especially when communicating to business or operational leaders, is to remember the organization’s goals and how this technology leads to those goals or contributes to the completion of those goals. It may be very clear to IT that if we execute this initiative, we're going to get to the XYZ goal. But that might not be clear to operations. So, it's important to draw those lines of connection.
Additionally, whether an assessment is from a consulting firm or advice from a vendor, it's important to remind leadership that patients have a choice in healthcare. If you aren't offering the latest functionality, patients may opt to go to an organization that does. Maybe they want texting or to pay their bill through a portal, those types of things. When you're talking to operational leadership, help draw that connection that patients have a choice. If you don't offer some of those technology options, you might fall behind.
Spend time on training and change management to boost user satisfaction and adoption
John Walsh: Facilities have lots of turnover so there's a lack of education and experience with MEDITECH, regardless of the release. There's no history behind why decisions were made or why the system was set up this way, because the person left. We help figure out how your system is set up and how we can make it more streamlined, safe for the patient, and easier to use.
It’s also important to keep your test and live in sync. It's not always done, but it makes it a lot easier to go through testing events. There's nothing worse than getting access to a system, and test looks nothing like live.
Quick wins are one of my favorite things. When we do an assessment, we can go to a user and say, hey, did you know you could do this? They say, well, I didn't even know that existed or I was told you can't do that. I love quick wins that solve a problem and it takes five minutes to show them. Next thing you know, they're educating others on how to do it.
Stephanie Murray: Regardless of what system you're on, change management is a huge piece. You can optimize all day long, but if you don't tell users what you're doing or how they have to use the system in a new way, or even train them, if it's a significant change, they're still going to keep doing the same thing they've always been doing the same way they've always been doing it.
Also, a consistent change management cycle is key because that helps users understand when to expect changes, how to digest those changes, how to adopt those changes. A consistent cycle gets users accustomed to the cadence of different optimization efforts or even maintenance, which will really help from both a short-term understanding and a long-term goal.
How CereCore assessments work
John Walsh: How these assessments work from a CereCore perspective is we typically assemble a team based off of the needs of the facility. If they say, hey, we're struggling with revenue cycle advanced clinicals, we'll bring out specific consultants that have that knowledge or subject matter experts. We're usually lucky enough to usually review their system in advance of these meetings so we can tell what might be a problem, and what they might be struggling with.
Then, I always like to make sure we meet with IT individually to get their side of the story, see what they're struggling with, what they would like to see done. We then talk to the department and hear their voice and say, okay, what are you guys struggling with? From that, we always have a detailed assessment that kind of walks through each item that we feel could be fixed or made better or streamlined.
We come up with a level of effort to provide to leadership explaining why this is needed and what the benefits are that can be given to that CFO to the CIO to the CEO. Software systems are consistently evolving so there are always changes going into MEDITECH or Epic or any other system. So if sites aren't aware of those changes, they could make a change and it could cause downstream issues. Or maybe they just don't know something's there that they've wanted to implement for years. That's what these assessments can bring out to facilities.
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