In the bustle of EHR implementation to meet compliance with the HITECH Act and Meaningful Use, there are EHR go-lives happening every day in all parts of the country. As EHR implementation experts’ clients are constantly asking, “How did you do this before? What can we learn from others? What is the magic bullet to a successful pain free EHR go-live? Unfortunately, there is no perfect answer. However, there are many lessons learned that we can share from our years of experience with go-live planning and execution.

1. Set clear expectations about change control

Be very clear with users what can and cannot be changed ‘on the fly’ during the go-live period. Define if you will only change break/fixes, spelling errors, patient safety issues, or if you have the manpower to take on more substantial changes.

2. Identify the communication and tracking process of change control

How will users make requests? How will they be prioritized to the support team who is correcting and testing the issues? If possible, use a ticket tracking system that allows support users access to real-time requests and status updates. Designate site leaders who will enter the ticket information and be the key point of contact for the support team. Set expectations on the time of turnaround for issues; should an acknowledgement be sent once the request is received, is there a timeline for closure on requests, etc.

3. Test connectivity and speed

Depending on the size of your organization, the way users access your EHR and the speed of their connection will vary. However, it is critical that some sort of load testing is performed PRIOR to go-live. Often the true volume of capacity is not truly testing until the first day and frequently found to be not enough to maintain speed needed for the number of users.

4. Have all users log into Production PRIOR to Go-Live

Once users have been trained, they should test their actual Production/Live EHR environment accounts. Have a check list by role that confirms all of their access is set up correctly prior to the first day. This can be easily done at the end of training. Many times users have not logged into the actual EHR environment they will be using, then find on the first day their setup and access is incorrect.

5. Have downtime procedures and don’t be afraid to use them

Downtime will happen in the life of any EHR; the extent and length of a downtime will vary between roles and the reasons for the downtime. It is imperative that downtime procedures are prepared in the event that part or all of the EHR is inaccessible to any user. A well-documented and executed downtime procedure will greatly assist in easing tension of users who are anxious to transition to the new technology. The team and its leadership need to carry this process through all areas of the organization that is going live in order to be successful.

We have discussed only a few of the many items that can bottleneck an EHR go-live event. With any new system change involving all areas of the organization, there will be confusion and points of failure to some degree. Our goal in sharing these high level items is to get your organization thinking about how well you are prepared to go live and learn how to avoid these missteps.