The journey to implementing an Electronic Health Record (EHR) requires a comprehensive process to define, deploy and test end-user devices. The device readiness process is time consuming, but an essential, critical pathway to EHR implementation success. Often, facilities do not prioritize this activity highly enough nor staff it appropriately, depriving healthcare providers of needed technology and causing healthcare delivery disruptions for the patient. There are 5 phases to the device readiness process:
- Planning
- Assessment
- Logistics and Deployment
- Testing and Validation
- Support
We’ll explore these phases and detail why you should work with experienced professionals to perform this crucial work to save time and money.
Planning
Planning begins with the collection of available documentation on physical location(s) where the EHR is to be deployed, such as maps, blueprints, department lists and facility lists. This current state documentation needs to contain the physical layout and list any already-deployed hardware. It is also during the planning stage that you may determine what the future state device standards will be, if existing workstations will be utilized or replaced (often the case in Merger and Acquisition (M&A) activity), device and department naming conventions, and future state workflows.
Creating the intended future state at this stage allows for translation of current state to future state during the next stage, assessment. Defining what providers will utilize; workstations, Workstations on Wheels (WOWs), mobile devices, wall-mounted devices, downtime devices, etc. The creation of a staffing plan and defining essential team members for the device readiness effort should also be conducted at this stage, if not already performed.
Assessment
Assessment is the capture and review of the physical environment and currently-deployed equipment. A well-planned current state inventory process should also include the involvement of Organization Change Management (OCM) and communications and marketing staff, as this may be the first tangible work that the general staff witness. Notification and communication plans to staff about these assessments will decrease anxiety and efforts should be made to minimize clinical and business disruptions by their activity.
The physical assessment and hands-on review process needs to be highly organized and efficient. A thorough assessment yielding discrete data can decrease the need for follow up visits by as much as 75%, saving considerable time and money.
Planning an EHR implementation? We can help with Device Readiness and more.
Logistics and Deployment
Logistics and Deployment involves the planning and execution of the procurement, storage, preparation, and distribution of the pieces of equipment (potentially thousands of them) that you will require for your EHR device rollout. Even when utilizing existing workstations, it is likely that you will need to deploy additional monitors, peripherals, and printers. You may want to use this as an opportunity to standardize on printers, barcode readers, document scanners, other peripheral devices as well as WOWs and wall mounts in use.
Careful planning and coordination with your purchasing personnel and your supply chain vendors is necessary to ensure smooth acquisition, purchase and delivery. As we have seen in the past few years, worldwide supply chain disruptions are possible and can have significant impacts on large scale projects. Decisions need to be made about the timing of distribution of the equipment. Some items, like workstations, may be able to be placed well ahead of EHR testing, while others may best be deployed just-in-time if they have no immediate use to reduce the chances of breakage, misplacement, or loss.
Testing and Validation
Testing and Validation of user workstations and peripherals is an integral step towards EHR go-live readiness. It’s critical to ensure that staff can access and interact with the software correctly, while also having fully functioning peripherals and the correct printer mapping for labels, reports, or any other output. Testing can comprise several phases, such as functional and script-based. Success will be determined by a facility’s ability to execute on the plan of physically reviewing each workstation and ensuring that all essential workflows will be possible from every device for each intended user. Utilizing an organized plan for conducting the scripts and for tracking progress, issues, and resolutions will be necessary to keep your project on time and to satisfy the equipment readiness elements of any go-live readiness plan.
Another validation step is to ensure that every user that will be utilizing the EHR and any other required software have active accounts and user rights. Hardware readiness, software configuration and user access must all be properly tested and validated to provide evidence for go-live readiness in order to reduce the number of issues reported at the time of go-live.
Support
Support of the newly deployed equipment during and after go-live can be thought of in two categories: immediate post-go-live support and long-term support. During the go-live and for a short time immediately following, most go-live plans call for a dedicated team to provide support alongside regular IT and informatics support personnel. This extended support period allows for the collection of issues for consideration across the project. Having dedicated staff that can quickly react and correct any issues such as device profile configuration, printer mapping, labeling issues or peripherals not being deployed where needed will increase user satisfaction and confidence in the EHR launch.
Once these initial issues are fleshed out, conversion to the facility’s normal support staff and structure can occur. Long term support and maintenance of the user workstations and peripherals should consist of ways to not only maintain the physical equipmentl but also maintain the key document artifacts that were used.
Implementing an EHR is a highly complex process that demands an orchestrated and well-planned approach to every aspect of the project. The device readiness process should not be considered just another technical deployment, but rather a multi-phased transformation of the user work environment. Each phase of the device readiness process requires different knowledge and skillsets, but all must align to the overall EHR design plan. The use of project management methodology along with multi-disciplinary involvement will ensure both a smooth deployment and improved care.
Working with vendor partners and consultants that are knowledgeable about this work – such as Divurgent – has proven to be cost effective and efficient. This allows IT, informatics, and clinical leadership to focus on the many other aspects of clinical transformation that require in-house leadership.
About the Author
Christopher Woodruff | Principal
Christopher is a Principal at Divurgent. He is an expert in EHR, Clinical, Business and ERP system implementations and optimization. Prior to joining Divurgent, he was System Director, Clinical Applications, at Bon Secours Health System. He also served in the United States Navy Reserves for over 30 years, achieving the rank of Commander. Visit Christopher on LinkedIn.
