of

EHR IMPLEMENTATION

The Agonyand

The Ecstasy

First Requirement?

• A Champion who is ready to put on the armor and fight for the project.

The Agony –It takes a long time

The Ecstasy –Finishing the Project correctly, on time and on budget

The Agony –It needs to be painfully detailed

The Ecstasy –Finishing the projectcorrectly, on time, and on budget

Have a detailed Project Plan- Hire a project manager- System Specifications- Complete a contract- Hardware and technology- Interfaces- Review policies & procedures- Education and training- Review workflows- Data conversion- Accounts Receivable run-out plan

The Agony – Make sure you pay for a lot of personnel during go-live

The Ecstasy –Problems get addressed quickly

Going live with the new practicemanagement system –APRIL 1

NorthPoint’s telephone experience

The Agony – Learning to make appointments with the new system causes long phone queues

The Ecstasy –There is a quick learning curve

Average Call Handling Time

0:00:000:00:430:01:260:02:100:02:530:03:360:04:190:05:020:05:460:06:29

Jan Feb Mar Apr 1 AM

Average Speed to Answer Incoming Calls

0:00:00

0:01:26

0:02:53

0:04:19

0:05:46

0:07:12

0:08:38

0:10:05

Jan Feb Mar Apr 1 AM

Percent of abandoned calls

0

10

20

30

40

50

60

70

Jan Feb Mar Apr 1 AM

Average Call Handling Time

0:00:000:00:430:01:260:02:100:02:530:03:360:04:190:05:020:05:460:06:29

Jan Feb Mar Apr1

AM

Apr1

PM

Apr2

AM

Apr2

PM

Apr3

AM

Apr3

PM

Apr4

Apr May Jun Jul

Average Speed to Answer Incoming Calls

0:00:000:01:260:02:530:04:190:05:460:07:120:08:380:10:05

Jan Feb Mar Apr1

AM

Apr1

PM

Apr2

AM

Apr2

PM

Apr3

AM

Apr3

PM

Apr4

Apr May Jun Jul

Percent of abandoned calls

010203040506070

Jan Feb Mar Apr1

AM

Apr1

PM

Apr2

AM

Apr2

PM

Apr3

AM

Apr3

PM

Apr4

Apr May Jun Jul

Going live with the new

practicemanagement

system –APRIL 1

NorthPoint’s cash flow experience

The Agony – Accounts Receivable can take a real battering

NPHWC Medical and Mental Health AccountsDays in Accounts Receivable

-10.0020.0030.0040.0050.0060.0070.0080.0090.00

Sep-08

Jul-08

May-08

Mar-08

Jan-08

Nov-07

Sep-07

Jul-07

May-07

Mar-07

Jan-07

Day

s of

Bus

ines

s in

A/R

Days in A/RNational Avg

The Ecstasy – New data and new reports helping to investigate the battering those receivables are taking

Lessons LearnedHardware & technology

• Budget enough dollars for installation of computers into rooms

• Set up a test exam room with equipment and turn staff loose on it

• Printers – what kind, how many, where• Connectivity for web based programs

Lessons LearnedInterfaces

• Keep to a minimum• Communicate clear expectations on who

is to do what, when and where

Lessons LearnedSecurity/HIPAA

• Where are computers/printers located• What are your time-outs• Audit trails of users accessing the system• Log-on ID’s and passwords

Lessons LearnedReport development

• Start early• Need an experienced report writer or

report analyst• Data is changing• Network with other users and find out what

is working for them

Lessons LearnedEducation & Training

• Staff need basic computer skills – typing, Windows, keyboarding

• Site visits and shadowing other clinics with the same software is helpful

• Set up a training center room

Lessons LearnedBuild and Test cycles

• Builds are complex, perhaps much more complex than previous systems

• Complete thorough testing with all kinds of patient permutations – involve your staff

• Testing does not insure implementation• Testing does not insure smooth sailing in a

real environment

EMR Implementation

Perhaps not the stuff of Hollywood

But it will still be an adventure for clinics going through it and beyond.