As the saying goes, you only get one chance to make a first impression. This applies to the go-live of an Electronic Health Record (EHR) system as well. The first two weeks post go-live will set the benchmark for provider satisfaction with the new EHR. This is especially true when bringing Ambulatory modules live as the provider users will often be in multiple locations, have varying hours of operations, and may have large disparities in workload from clinic to clinic.
One of the most effective ways to drive provider engagement and adoption is providing “At the Elbow”, (ATE) support. During the first impression stage, ATE provides positive, individualized and timely assistance to this very visible user group. Below we’ll outline several key considerations when planning go-live support for your providers.
- ATE Staff: Finding experienced, knowledgeable staff is key to delivering a positive support experience to the provider group. Our best practice is to provide ATE through a dedicated team specialized in go-live training and support. This group of individuals focuses on providing support for multiple EHR systems including MEDITECH, Epic, and Cerner. Preparation for provider support typically begins with a two to three hour session reviewing the latest EHR version changes, site-specific customizations, and site-specific processes.
- Staffing Ratios: The ideal provider to ATE support staff ratio can vary depending on provider experience with EHR systems and the setting, acute versus the clinic environment. As a starting point, a staffing ratio of one ATE staffer to three providers generally provides adequate coverage. That said, it is highly recommended that you get to know the providers, and their comfort level with EMR and electronic documentation, so that you can prioritize any individuals that may require more intensive support.
- Logistics: One of our most recent ATE teams totaled thirty individuals in one location. That number could overwhelm local hotels depending on the size of the community. Therefore, ensuring the logistics, hotels, rental cars, flights, are nailed down early is essential. Also key in this area is ensuring that the staff you bring in is familiar and compliant with time and expense reporting and policies. A final note on logistics, it is helpful if the ATE support staff are easily identifiable by the providers. To that end we’ve used custom-colored shirts, brightly colored and highly visible badges, and on some occasions, bandannas.
- Communication: It may seem a bit obvious, but setting up clear lines of communication is essential. Group text/messaging will allow ATE staff to share information, fixes, work-around processes, and common issues. Additionally, holding daily 30 minute huddles via conference calls allow project leadership to “check the pulse” of other sites and clinics.
- Preventing fatigue: Again with the obvious, but depending on the number of sites going live, getting the schedule finalized can be a challenge. Be sure to review hours of operation during planning sessions with sites, especially if there are any variations. Most ATE support staff are ready to work 10-12 hour days, but in 7 day a week operation like an Urgent Care clinic it is important to give the ATE team a rest day to ensure they don’t get too fatigued.
A successful EHR go-live is critical to maintaining a high-level of quality patient care for all organizations. Keeping providers top of mind when planning go-live support will go a long way to allowing them to focus on patients, their care, and minimize any disruption related to utilizing a new EHR.
