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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3 Roles to Support EHR Optimization

3 Roles to Support EHR Optimization | EHR and Health IT Consulting |

Technology should make it easier for Physicians to get their work done, right?  I mean, it seems to work in all other industries and most other aspects of our lives. So, why should healthcare be any different? Well, the fact remains that healthcare is very different. Physicians are trained to be independent thinkers using all available data. Each patient looks for a personalized decision to improve their health and wellbeing.


This autonomy of clinical practice is generally not compatible with most of today’s electronic health record (EHR) systems, which has led to a decrease in clinical efficiency and growing frustration for all care team members. While this individualized approach may seem beneficial, advances in medicine and surgery have identified uniform diagnostic and treatment protocols that lead to better patient outcomes in all disease categories.


Further, regulatory and payor data collection requirements have added layers of additional burdens to health systems that require the use of standardized technology systems. Optimization is making the best or most effective use of a situation or resource. Within healthcare, this means EHR Optimization.


As healthcare systems look to optimize Physician workflows, they should invest in three key supporting roles to help ensure success.


1. Process Improvement Specialists - In general, to reliably achieve results, you need a standard approach. A variation in approach leads to a variation of results; this applies to clinical practice as well. Before any new tool, whether it’s a scalpel or an order set, is given to a Physician, all care team members, especially the Physicians, need to understand how that tool will make them more efficient and why it’s effective in driving a particular outcome.


If that tool does not enable both tasks, it will likely not be adopted. High performing healthcare organizations understand that concept and intentionally leverage Process Improvement Specialists to focus their efforts on the process before implementing a transformation initiative.


They carefully map out the steps for each standardized process and look to understand how technology and insights can provide value along the way. Once a new process is defined, a change management education plan is formulated based on the gap between current and future state.


This is an absolute requirement before considering implementing new IT functionality. Otherwise, end-user adoption and optimization will be much more challenging.


2. Application Solutions Analysts - As successful organizations design standardized processes, they look to technologists to help them work smarter and not harder.  Typically, Application Solutions Analysts serve in that capacity.


These individuals are not only well versed in the functional capabilities of the core EHR system but are also in tune with the industry's best practices for a given process. The “out of the box” functionality promoted by EHR vendors rarely fit ideal workflows and almost always require some amount of configuration to meet the organization’s best practice process.


Furthermore, there is often decision support logic or machine learning algorithms that Physicians can leverage to enhance the diagnosis and treatment of patients. To drive innovation, healthcare teams must understand the “art of the possible” from their core systems and incorporate new capabilities into their workflows.


3. Insight Engineers - The third leg of the optimization stool is the measurement.  If you can’t measure it, you can’t manage it. Many health systems fall short with the adoption of change simply because they lack the data needed to measure the on-going success (or failure) of their initiatives. Insight Engineers, skilled in measuring lead and lag key performance indicators (KPIs), are valuable participants to the change management process as they bridge the divide between the care delivery teams and the IT analytics/informatics teams.


They work with subject matter experts, Applications Solution Analysts, and Process Improvement Specialists to define actionable KPIs that care teams will use to achieve their goals and work with the IT teams to deliver them before go-live.


Clinicians and operators need to understand compliance and variation to process in real-time or near-real-time to achieve sustainable clinical outcomes.


For example, knowing which Physician is deviating from a specific component of sepsis protocol at the moment is much more impactful to course-correcting behavior than finding out 45 days later in an aggregated report. Without actionable dashboards, leadership will struggle to hold all teams accountable for the care delivered.

Technical Dr. Inc.'s insight:
Contact Details : or 877-910-0004

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Pro-Active EHR Optimization is a Necessity

Pro-Active EHR Optimization is a Necessity | EHR and Health IT Consulting |

Everyone knows that routine maintenance is required to keep a home, car, or even a person in good shape and performing well.  The same is true in regards to our electronic health records (EHR).  To meet the requirements and capitalize on the benefits of meaningful use, the US market has seen an unprecedented amount of EHR implementations. However, many organizations aren’t seeing the expected benefits.


Factors such as rushed, system-focused implementations, lack of standardization or focus on workflows, end-user and physician dissatisfaction, high ticket, and request volumes, and/or sub-optimal training are major drivers for optimization needs. Routine maintenance and pro-active EHR optimization are a constant and ongoing necessity and should be treated that way from a planning, budgeting and prioritization perspective. Here are some key areas to consider in a post-EHR go live world.


Thorough Assessment, Prioritization, and Management of Current Issues and Complaints


Most organizations use a ticketing system to log EHR issues. Following an EHR activation, ticket volumes often increase to the point where an organization cannot manage the volume and cannot differentiate priority issues from common, organizational issues. This is exacerbated by the constant “pull” of resources that are now needed for other organizational objectives and projects.


The truth is, your EHR “project” doesn’t go away when the system goes live. Rather, a program management organization, complete with an integrated Governance structure, must remain to manage upgrades, maintenance, and optimization. A great first step is understanding issues and prioritizing ongoing efforts for your teams and your organization


A thorough review, cleanup, validation, and categorization of all issues should be conducted. This requires the establishment and ongoing execution of a ticket intake and review process that identifies the priority and necessity, understands the source of the problem (e.g., user proficiency, workflow inefficiency, build defects) and reconciles that against the objectives of the organization. It is critical to include operational and clinical leaders in this process and often requires time for interviewing and even shadowing clinical and operational users to fully understand and accurately document issues.


Categorizing, Prioritizing, Integrating and Approving Effort


Most issues can be categorized into four areas:

  1. Break/Fix
    • Break/fix are issues with the software functionality that need to be fixed by either the IT analysts or vendor.
  2. System Enhancement
    • Enhancement issues pertain to desired functionality that is either not yet developed by the vendor or not yet implemented by the IT department.
  3. Workflow
    • Workflow issues arise when a process or procedure is inefficient.
  4. Training
    • Training issues occur when the system is functioning as designed but the end user is unaware of how to use it properly. Training may also be needed to teach advanced functionality.


After categorization, issues should be prioritized. The prioritization process should be carried out through the Program Management and Governance structure and is typically not simply an “IT” process.  Understanding the issues and requests, prioritizing them against the organizational objectives and then including them in the ongoing capital and operating plans allows adequate focus, funding, and validation for the work.


This may be simple and quick – break/fix items, refresher training, etc. However, the focus may be more complex and cross multiple areas of the organization – new system functionality, upgrades, workflow redesign, etc.  The latter often requires the organization to move back into “project mode” with a detailed timeline, project plan and in some cases, capital funding.


Optimization Implementation and Ongoing Maintenance


Now that a structure is in place, resources are adequately funded and work is prioritized, the organization can move forward knowing that the EHR can be properly maintained, but also leveraged for its true functionality. There will be many moving parts that may involve system configuration, system upgrades, workflow redesign, and end user training.


Having a dedicated optimization team and project manager that interacts and coordinates with the key operational and clinical leaders is key to ensuring success, but also aides in optimizing an EHR solution that supports the organization’s objectives as well as the patient experience.

Technical Dr. Inc.'s insight:
Contact Details : or 877-910-0004

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3 EHR Optimization Benchmarks Your Practice Should Be Using

3 EHR Optimization Benchmarks Your Practice Should Be Using | EHR and Health IT Consulting |

Following the implementation of an electronic health records (EHR) system, optimization should be the next critical objective for a medical practice. One way to plan a road-map for optimization is to generate benchmarks.

Below are three important benchmarks to help your practice determine if you’re getting the most out of your EHR system.

  1. Computerized Physician Order Entry Indicators

Some of the most important benchmarks in EHR optimization center around computerized physician order entry (CPOE) indicators. These indicators are critical for identifying the efficiency of an EHR, and complying with Meaningful Userequirements. Fortunately, these are often easy to benchmark. For instance, one indicator for a practice with a high volume of electronic prescribing is the number of pharmacist calls regarding contraindicating medications. This indicator is simple to follow, and can inform a practice whether or not an EHR system’s Clinical Decision Support (CDS) alerts or notifications are effective.

Other CPOE indicators that are simple to follow include anything from provider and staff logins to printer use and more. Bottlenecks in data entry can also indicate issues with in-house adoption and areas that could benefit from optimization.

Setting benchmarks for these indicators are an important way to track post-implementation optimization for an EHR system.

  1. Alignment and Standardization of Use

One very common area in need of optimization post-EHR implementation is standardization of workflows. Technicians, nurses, medical assistants, providers, and staff may all do the same task differently. While there will always be slight variation in workflows between team members, major differences (i.e. printing and scanning a document rather than importing data electronically) can lead to large gaps in optimization further down the road. Fortunately, this is measurable, and can be an important indicator to monitor as you optimize your EHR system. Striving for benchmarks within certain tasks and workflows, such as importing medical histories or documenting in-office medications, can help to clarify standardization (or the need for standardization) within a medical practice.

  1. Revenue Cycle Management Indicators

Successful implementation of an electronic records system should reflect financial benefits as well as positive workflow and improved patient indicators. Therefore, important benchmarks in EHR optimization include Revenue Cycle Management (RCM) indicators. Leveraging costs per provider vs. clinic volume before and after implementation (taking into consideration training and adoption periods) can help clarify areas that need further optimization. This may involve taking a closer look at EHR pricing models and what the practice’s needs are heading into the future, along with considerations such as personnel volume, clinic growth, federal reimbursements, and more.

Making Benchmarking Actionable

Benchmarking may begin as a method of determining the efficiency of an EHR system, but it doesn’t stop there. Monitoring indicators and determining strategies to achieve those goals also aligns a practice with the many objectives of electronic health records in the first place: improved patient safety, thorough documentation, and more efficient workflows, to name a few. Therefore, making benchmarking actionable is critical for the health of the entire practice and its patients. Creating teams to address issues with optimization and working through kinks in workflows after benchmarking and monitoring is the next step to operating a truly successful EHR system.

Technical Dr. Inc.'s insight:

Contact Details : or 877-910-0004

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Points to Consider for EHR Optimization

Points to Consider for EHR Optimization | EHR and Health IT Consulting |

It is often said that implementing a new electronic health record (EHR) is just the beginning of a journey that will lead to better patient care, greater efficiencies and improved return on investment. It is true that the work will continue, so it is worth pondering how you will approach the post go-live world.  It’s not enough to install EHR software.  


It could be argued that tailoring the EHR to your organizational needs and implementing new functionality is where the real work lies.  This much is clear though, EHR optimization is vital to your organization’s successful long-term use of the EHR.  Below are some tips to help you think through the challenges ahead.


Plan Early

Start planning for how you will approach and manage your IT investments early.  Putting your plan together even before your implementation begins is not too soon.  Your plan should include an outline of what you will undertake during the implementation and what can wait, or should wait, until after the implementation phase is complete.  For example, it may make sense to wait and deploy some population health tools after go-live.


Tie Plans and Programs to Organizational Strategy

IT strategies should mirror the strategies of the organization.  For example, many organizations are actively exploring mergers and acquisitions.  IT leaders should understand the outlook for the organization and any challenges that lie ahead and have a plan to grow the IT environment appropriately when the EHR optimization phase begins.


Establish Strong Governance

Having a strong governance structure from the beginning is critical, but tweak the structure as needed during both implementation and post go-live phases.  The decisions that need to be made post go-live will likely be different from those made during the implementation phase.  Adjust the membership on the committee when needed to ensure that the proper stakeholders are represented and engaged.


Manage Change

Change management is a necessary activity throughout the implementation and as the EHR evolves post go-live.  Not only will the business practices and workflows change but people’s roles will change as well.  It is important to communicate early and often regarding changes so that employees understand the “why” of the change and “how” the change will affect them.


Standardize and Innovate

This topic may seem like an oxymoron – it is not.  Standardizing where it makes sense such as standardizing workflows, project management toolsets and methodologies, will allow for a stable environment post go-live. Stability lends itself to innovation because chaos is contained and a certain amount of predictability occurs.


This stability will allow creativity and innovation to thrive.  One area to pay close attention to is enterprise reporting.  Resist the temptation to merely recreate your current reports and instead approach report development and distribution as a way to improve operations and show off the power of your new system.


Contain Costs

Once the initial, and substantial, cost of implementation is behind you, the CFO and other executives will look for cost containment, even reductions.  Consider strategies to contain costs such as targeted outsourcing. Explore cost reduction strategies as well, such as consolidation and eliminating legacy systems as quickly as possible.


IT Shift

The IT staff will be exhausted after many months of intense pressure to get the system up and running smoothly.  The pressure will continue post go-live as EHR optimization becomes the focus.  Be sensitive to your staff’s needs, both inside and outside of IT, as they refresh and regroup.  Have a plan in place to maintain proper staffing as well as give your teams some much needed time away. 


HR departments can help with this plan. Also, added skills such as reporting and analytics, will be in higher demand during the EHR optimization phase as greater emphasis is placed on data and its value in improving patient care and operations.


Conversion and Archiving

Have a plan for the method and technology needed to convert data from your legacy systems to the new systems early on.  You need to specify the minimum data set that you will convert.  In addition, some departments, for example, Oncology, may have special conversion requirements.  


Also, figure out an archiving solution well ahead of time.  The archiving solution should account for easy access to the data that did not convert to the new system.


As with all EHR changes, proper guidance and preparation can be the difference between success and failure.  The outline above can get you started, but also consider outside resources such as those at Optimum Healthcare IT. Experts in the art of EHR Optimization bring insights that can only be gained through experience.




Technical Dr. Inc.'s insight:
Contact Details : or 877-910-0004

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3 Key Areas to Address During EHR Optimization

3 Key Areas to Address During EHR Optimization | EHR and Health IT Consulting |

If you have ever purchased a new home, you are rarely 100% satisfied when you move in. You may want to add some new furniture, paint a few walls, update the flooring or even do a complete remodel. When implementing a new Electronic Health Record (EHR), many times the need to “get the system live” as soon as possible, results in a rushed implementation of basic functionality and “out of the box” workflows.


There is not always time to look at current issues and identify ways to improve processes. Many times the current problems are merely transferred into the new system. Even if you love everything about your new EHR, Optimization of the system will always be necessary due to factors such as advances in medical treatment, compliance & regulatory changes, adding of new specialties and more.


Whether it is your existing EHR or a new system, for optimization to be effective, experts with clinical, operational and technical experience will need to look at how the system is working. You may have such experts employed, or you may need to bring in consultants. Either way, these experts will assess how users are interacting with the EHR and if they are having functionality and/or workflow issues. Sometimes, problems can be addressed by merely providing additional training, especially if new features and functionality have been deployed.


By taking a thorough look at the system and its users, experts can determine what improvements need to be made.

Below are three areas to take into consideration: 

  1. Governance: A strong governance structure is critical to having a successful optimization plan. Requests for changes to the EHR must be prioritized and evaluated.  An agile governance group made up of the right members, should meet monthly to review all requests and prioritize according to the overall needs of the organization.
  2. Training:  A comprehensive training program is a critical factor that impacts the usability of the EHR. Many times organizations provide new employee training but do not offer any “ongoing” or “refresher” training. Supplemental training can increase basic and advanced knowledge of the system and improve efficiency. As system upgrades and new functionality are implemented, users should have an option to attend classroom training. eLearning can be helpful, but there is no substitute for hands-on classroom training where the user can ask questions and get answers.
  3. Communication: Organizations should have effective and comprehensive communications regarding training, new functionality, and any other changes to the EHR. The creation of a formal enterprise-wide communication plan using a variety of forums and a broad spectrum of communications resources is essential. Being proactive versus reactive such as having the EHR topic as a standing agenda item at a section and other scheduled MD meetings can be very useful.
Technical Dr. Inc.'s insight:
Contact Details : or 877-910-0004

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