Centra, which includes Centra Lynchburg General Hospital, Central Virginia Baptist Hospital and Centra Southside Community Hospital, recently rolled out McKesson Horizon, Clinicals and Star Financials. (In a separate interview, Clark notes that pretty much all of his regional rivals have gone with Epic — so congrats to him and his colleagues for keeping an open mind.)
Clark’s thoughts include the following, according to the Becker’s piece:
* Leadership counts. Everyone from the CEO to the department head need to be “preaching day in and day out as they build the process that this is important,” he says.
* Don’t neglect training costs. Make sure you don’t skimp on your training budget . At Centra, it took more than six weeks to train its 2,400-odd employees, and was “quite an expense,” Clark notes.
* Consider phasing in your implementation. Centra rolled out its EHR gradually, at a single location, before it did a system-wide implementation.
Not only did this made it easier to support the process, complete with helpers on site in areas where physicians were working, it gave doctors a chance to pick up skills gradually.
* Prepare to answer doctor questions quickly. To put doctors at ease, Centra made sure key medical staff thought leaders, nurses and others were part of a clinical informatics team designed to help with support. The team made daily rounds and made themselves available for EHR questions.
* Workflow changes can drag on. Be aware that workflow changes won’t come easily for many staff members. For example, he notes, nurses may have to work in “two worlds” (electronic and paper) while they integrated the EHR into their daily processes.
Another example: doctors who aren’t big admitters might be reluctant to learn the CPOE processes at first, and they’ll have to be phased in gradually.
* You’ll need a stable wireless network and lots of hardware. Clark told Becker’s that he was surprised to find out how problematic the wireless connection turned out to be. As it turned out, access point locations, issues with laptop and nursing cart software and battery life were concerns, so all had to be addressed early on.
Clark also had to train users how to work in a mobile environment, as some problems came from lack of knowledge about the network. What’s more, Centra had to invest in a surprisingly large amount of new hardware to make the EHR accessible to everyone during peak times, such as 7AM rounds.
My guess is that you could come up with six (or 60) more ideas on how to survive implementation, readers. In particular, I’d love to hear what input you’d have on how you dealt with technical challenges (especially bugs) during the early stages of adoption. Fire away!