EHR and Health IT Consulting
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EHR and Health IT Consulting
Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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4 Stumbling Blocks to Avoid in System Implementation

4 Stumbling Blocks to Avoid in System Implementation | EHR and Health IT Consulting |

Every organization, at one time or another, goes through some type of system upgrade or implementation. Common practice is to develop a very detailed project plan. These documents are laid out to ensure that all tasks are performed and that all deadlines are met. Meetings are scheduled, milestones are agreed upon, and staff are informed of what to expect. Unfortunately what may look like a well thought out plan on paper may not address the day-to-day issues that can often disrupt a thoughtful plan.

So how do you prevent this kind of interruption? It is good practice to think about possible stumbling blocks that can cause employee angst, reworking of project plans, and/or potential deadline delays. Take a look at the following potential road blocks and how to prevent them.

Potential stumbling blocks:

  • Calendar disruptors – Consider outside elements that may cause changes to the calendar. For example, are there holidays which need to be taken into account during the timeline development? A long three day weekend, like Memorial Day, typically means a reduced staff for testing and training. In the northeast, is it wise to plan for a winter go-live? In Florida, which of the months could impact a successful project during hurricane season? Weather conditions can have the potential to wreak havoc on a well thought out project plan.
  • Business office constraints – Take a look at potential business office constraints. If the expectation is to have business office staff training during month end close it is unlikely that those training sessions will be well attended. Are there any other upgrades or implementations that may be going on at the same time? If so, there may be a limited resource pool to pull from. Keep in mind that employees may already be concerned if they are currently spread too thin.
  • Training and testing limitations – Depending on the size of the office that is scheduled to attend training or provide testing assistance take all schedules and workloads into consideration. If it is a small office, where each provider has a heavy schedule, how likely will it be that staff can attend training classes or testing assistance while ensuring that patient care is not being compromised? Look at additional resources or supplemental staff to fill in so staff can leave the office and attend training sessions.
  • Inadequate go-live support – Another component worthy of evaluation and consideration is go-live support. Most organizations incorporate a “help line” to aid the staff after a go-live. But what happens to that large practice that has a long line of patients, phones ringing, providers requiring attention, and employee anxiety? There needs to be a plan in place to circle back with those practices and make sure they are getting the necessary support.

To ensure your system implementation goes smoothly, consider the following steps:

  • Develop a well thought out project plan.
  • Make sure the objectives are clear.
  • Coordinate training schedule with business office needs.
  • Allocate resources and back-up plans early in the planning process.
  • Provide consistent and clear communication.

It is important to understand that little changes may impact well intentioned go-live of a system implementation. A well thought out project plan that accounts for these stumbling blocks and has contingencies built in will help to ensure a successful go-live. You can then focus on ensuring employee and patient satisfaction, which helps everyone in the long run.

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ICD-10 'war' continues | Healthcare IT News

ICD-10 'war' continues | Healthcare IT News | EHR and Health IT Consulting |

In some quarters, vigorous opposition to ICD-10 implementation is turning into guerrilla warfare.

The Texas Medical Association is encouraging physicians to lobby Congress for a two-year ICD-10 delay. They even provide the text that physicians should cut and paste onto their personal stationery.

The TMA letter cites the number of ICD-10 codes, costs, reimbursement delays and competing federal mandates. Nothing new here.

It's the call to action that I find interesting:

"Please tell Speaker Boehner, Chairman Fred Upton, and Chairman Pete Sessions that you want to add the ICD-10 delay to a must-pass piece of legislation during the upcoming 2014 lame duck session."

This is how the Protecting Access to Medicare Act of 2014 became the vehicle to delay ICD-10 implementation earlier this year. It could work again, because there might not be anyone in Congress who cares enough about ICD-10 implementation to try to strip out any anti-ICD-10 amendments.
But maybe that will change. The ICD-10 Coalition has its own letter urging Congress to keep ICD-10 on track. Unfortunately, I'm not sure such letters have any effect beyond being able to say the authors are on record for or against issues.

The American Health Information Management Association took to Twitter to rev up its #ICD10Matters campaign. Social media campaigns are the 21st Century version of TMA's letters. The AHIMA effort also reminded Congress of its upcoming information-sharing session on Capitol Hill this fall.

And that's not the only way AHIMA is fighting fire with fire. Its own analysis of ICD-10 costs seeks to counter the fears physicians have about how much the ICD-10 transition will cost. Unfortunately, it appears a little thin compared to the Nachimson Advisors report — which it seems to marginalize. Understandably, Stanley Nachimson hits back with a statement explaining why the new ICD-10 cost analysis is wrong.
The Nachimson rebuttal emphasizes its assessment of productivity loss for physicians in small practices -- which he suggests is about 10 percent. That's something you never see the American Medical Association (AMA) quoting.

So be on the lookout for the next piece of healthcare legislation going up before Congress. It might become the next battle for ICD-10 survival.

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