Implementing an EHR is more complex than just replacing the paper chart with an electronic version of it. EHR implementation requires transformational change in the physician practice. Most people can relate to the fact that change can be difficult; so, as part of the EHR project management planning phase, attention must be given to the culture change necessary for a successful and less stressful EHR transformation and deployment. Managing the cultural change process is critical to the success of implementing an EHR. In fact, implementing an EHR is not all about the system; it is about embracing the change necessary to integrate the EHR into how the physician practices medicine.
How Do We Manage Change?
Although change is critical, it is also important to manage and prioritize the changes being asked of a clinical practice. The first step is to define the vision of the project. This should be completed at the time the Project Manager establishes a Project Charter for the EHR implementation.
Communicating vision and goals to involved parties is an important element in managing change. People tend to feel better about change once they gain an understanding of it and have an opportunity to provide input into the change process. A good time to get input from staff is during the operational redesign process.
For cultural change to be effective, practices should be sensitive to what else is going on in the office and, for that matter, in people’s lives. Knowing as much as one can about physician practices and their staff will assist in mapping out and communicating the best approach for implementation. The introduction of an EHR into a physician practice also creates opportunities for freeing up certain staff resources to do other, more value added tasks.
Knowing the computer skill readiness of the staff and physicians (basic computer skills, understanding of EHR terminology, etc.) is important in planning the implementation. The communication process should include a clear framework for how staff will become proficient with the EHR.
Communication is Important
It is vital that all participants involved with the EHR project sense the support and guidance of their practice leaders. Both physicians and Practice Administrators need to speak in a unified, enthusiastic tone about the project and how it will impact everyone involved. They need to speak and listen directly to all levels of the practice (clinical and administrative). A confident and convinced team focused on a vision and guided by clearly defined, strategic, measurable goals will drive the successful adoption of the EHR project.
Full encouragement and communication from Practice Administrators/Office Managers is important for both effective implementation as well as sustainable improvement. There should be a plan in place to communicate the specific benefits of the changes to all staff. People need to feel as if they have a personal stake in the success of the EHR project.
Finally, to ensure the acceptance and confidence of all staff involved in bringing changes to reality, it will be important to communicate the way in which the solutions were initially created and planned. If the perception in the practice is that support staff had no input into creating changes that will affect workflow, resistance is more likely to occur. If it is understood, however, that all participants were consulted, acceptance is better guaranteed.
Making a commitment to incorporate cultural change methodologies and practices as part of the EHR implementation project is essential to the overall realization of the project. Culture change must be an integral part of the EHR implementation project plan; it should not be taken on informally, nor should the need for it be put off or ignored.