How To Implement An EHR Without Interrupting Your ‘Flow'

By Katie Wike, contributing writer

Choosing and installing a new EHR is exciting and has the potential to greatly improve the care provided by your organization, but preparation is key for a smooth transition.

Change is hard, especially when everyone in an organization is required to change their daily workflow for a new EHR. Working with a new EHR can be overwhelming if staff is not ready - but there are a few preparations you can make to make sure your new EHR doesn’t leave your employees feeling frustrated.

According to Noelle Whang, Sr. Instructional Designer at The Breakaway Group (A Xerox Company), “Mapping and redesigning workflows is an important aspect of EHR implementation and optimization that is often overlooked, especially after the application has been live for a while.” In order to create a smooth transition with your EHR, follow a few preparation steps that will make implementation a breeze:

Identify what workflows will need to be mapped in detail, then identify the teams that will map them and the mapping process. “It’s helpful to first map out the entire patient care process at a high level, such as from registration to discharge in the inpatient setting and scheduling to check-out in the ambulatory setting,” explains Whang. Some tasks will need to be mapped out in detail, such as scheduling a patient appointment or placing verbal orders. Also, identify the roles involved in each workflow. “For example,” says Whang, “discharging a patient from Labor and Delivery may include roles, such as a lactation nurse and pediatrician, not found in other departments.”

Then, Whang suggests the next step should be to identify those in charge of the mapping. Generally, it’s best to choose people who perform the duties involved in the particular workflow to help map a new one. “For example, select one registrar, one nurse and one physician to map out all workflows in the Emergency Department. Once the team has been identified, determine how information about workflows will be gathered, documented, and visually represented,” says Whang.

Analyze and document the workflow. Use a simple line chart or Word document to outline your workflow. Once the workflows are diagramed, begin the analysis. Once the analysis is complete and you have determined what workflows are currently not working for your organization, document the new and improved workflow. “It is a good idea to take the new workflows through a couple of use-case scenarios to ensure that the updates are not causing other problems or unintended consequences,” says Whang.

Be open to the idea that the workflow can change. “As the staff uses the EHR more frequently, they may find shortcuts or workarounds that make sense to their personal or team workflow,” explains Greenway Health. They also suggest holding regular meetings to determine any modifications that would improve efficiency. “It’s vital to communicate with staff frequently with any changes or updates. Choose the methods that work best for your organization. Think about utilizing an online staff portal, quarterly office manager meetings, luncheons and regular email communications with staff members.” Whang notes that this can include determining consequences for any end users that do not adhere to the new workflows. This also requires thinking about how non-adherence will be identified, perhaps through routine application audits or quarterly in-department observation.

Train staff. After all the hard lifting of creating the workflow diagrams, analyzing the processes and updating the workflows, the last step is to train end users on the new workflows, policies and procedures. “Physicians and staff may resist change in the beginning, but once the focus is on long-term goals, the advantages of the EHR become much clearer – immediate access to the patient’s complete record from virtually any location with mobile devices, more-accurate coding, improved workflows, and increased overall financial health of the organization,” explains Greenway Health. “A few weeks or months later, both patients and staff will see personal progress in using the EHR, and it will be both reassuring and encouraging.”