EHR Implementation: Starting with Pre-Configured Solutions

January 8, 2019

EHR Implementation:

Starting with Pre-Configured Solutions

Each year hospital IT departments are tasked with more projects on an ever-shrinking budget. Consulting firms, like Excite Health Partners, continue to strive for ways to provide the most value to clients.

Vendors alike are also trying to provide more value.  EHR vendors focus on a “Community Model” which is typically a standard product already “configured”.  As hospitals continue to use a standard, or community model, provider satisfaction issues continue to rise. While often a stronger cost-efficient option, this can lead to a prolonged workflow processes and several user issues.

Today, smaller hospitals are leaning towards a “standard” preconfigured products and services out of necessity. However, downfalls still exist:

  • The system still must be configured for your hospital system
  • Hidden costs
  • End User Satisfaction

Regardless of the alterations an EHR vendor can make to their “standard” package, it still can lack the specifications of the hospital. For example, the system isn’t configured to know what a cardiac surgeons favorite order sets includes. It is not configured to send orders to the preferred lab system. Even by using the “standard” package with modifications, the system overall, still needs to be configured. This leads to hidden costs.

EHR vendors are likely to estimate the scope and size of the project to be lower on the spectrum, with the assumption the hospital’s IT team can handle issues that arise. This frequently means consulting services are needed. Vendor implementation teams tend be stretched thin, often with high amounts of turn over and less experienced resources.  Identifying a 3rd party or trusted advisor to help provide stronger resources can help address the issues that arise. While hidden costs are expected with large hospital IT projects, today vendors offer minimal services due to the ability to preconfigure systems. These systems are rarely an exact fit for the hospital’s needs.

End User Satisfaction also plays an important role. The “standard” package from the vendor is heavily preconfigured meaning less decisions are needed to be made. Hospitals that take this approach are required to alter the workflows to accommodate the software, instead of altering the software to accommodate the workflow. For any given workflow within a large healthcare system, variations for processes exist. Although, a vendor’s “standard” can be a good thing, but not in all cases. Only deviate from the “standard” when needed. Use SBAR (Situation Background Assessment Recommendation) to assess and reason why deviations are needed. Common reasons for deviations are:

  • Patient safety and regulations
  • Financial implication
  • Time savings for End Users
  • The complexity of your systems environment and the way you need to conduct business

For end users with preconfigured system, very few decisions need to be made. Leaving the question what can be changed about the system to improve end user satisfaction?

Chief Financial Officer, Dave MacDougall, from UHS Binghamton NY found a solution. During the EHR pre-implementation planning efforts, one deliverable produced was an End-User Road Map. This allowed the team working on the End-User Road Map to direct focus on items needed to configure to increase end user satisfaction. The team also highlighted not only where configurations could be made within the application, but what from the vendor’s app store could be used in conjunction with the EHR system. The team shifted focused to what can be modified and at what cost.

Don’t take for granted the EHR vendor will get it done- make end user satisfaction a priority during implementation.

Todd Klein

VP EHR Services & Digital Solutions