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How to Implement EHRs

Step 1: Assess Your Practice Readiness

  1. Assess Your Practice Readiness
  2. Plan Your Approach
  3. Select or Upgrade to a Certified EHR
  4. Conduct Training & Implement an EHR System
  5. Achieve Meaningful Use
  6. Continue Quality Improvement

View tools for Step 1

The assessment phase is foundational to all other EHR implementation steps, and involves determining if the practice is ready to make the change from paper records to electronic health records (EHRs), or to upgrade their current system to a new certified version.

Why Implement EHRs?

More importantly, the assessment phase should address the following question: “WHY” implement EHRs? This EHR implementation step should help practice leadership evaluate their current state to determine what is working well and what can be improved. Some of the questions providers ask themselves during this phase include:

  • “Am I accomplishing what I thought I would be doing when I decided to go to medical school?”
  • “Are we providing the best possible care to our patients, or are we simply trying to make it through the week?”
  • “If I had more time, what would I do differently?”
  • “What would it be like to leave the office yet stay connected to my practice?”

At this stage, practice leadership and staff should consider the practice’s clinical goals, needs, financial and technical readiness as they transition.

Assess Your Current Practice

The assessment should look at the current state of the practice:

  • Are administrative processes organized, efficient, and well documented?
  • Are clinical workflows efficient, clearly mapped out, and understood by all staff?
  • Are data collection and reporting processes well established and documented?
  • Are staff members computer literate and comfortable with information technology?
  • Does the practice have access to high-speed internet connectivity?
  • Does the practice have access to the financial capital required to purchase new or additional hardware?
  • Are there clinical priorities or needs that should be addressed?
  • Does the practice have specialty specific requirements?

Through the Regional Extension Centers (RECs), we’ve learned that these questions and assessment tools provide a good understanding of the current state of the practice and can help identify key goals for improvement. Often, these goals relate to patient quality, patient satisfaction, practice productivity and efficiency, improved quality of work environment, and most important to the overall goal – improved health care.

Envision the Future

The next EHR implementation step is to envision the future state of the practice. What would the practice leadership like to see different in the future? More specifically:

  • What will be different for the patients?
  • What will be different for the providers?
  • What will be different for the staff?

Set Goals

Goals and needs should be documented to help guide decision-making throughout the implementation process. And they may need to be re-assessed throughout the EHR implementation steps to ensure a smooth transition for the practice and all staff.

We recommend that you set goals in areas that are important and meaningful to your practice. These may be clinical goals, revenue goals, or goals around work environment. Goals in all three areas will help assure balanced processes after the implementation. Goals that are important to you will help you and your staff through the change process. We recommend you follow the “SMART” goals process. This process includes setting objectives and goals that meet the following criteria:

  • Specific – Achieving the goal would make a difference for our patients and our practice
  • Measureable – We can quantify the current level and the target goal
  • Attainable – Although the goal may be a stretch, we can achieve it
  • Relevant – This is worth the effort
  • Time bound – There are deadlines and opportunities to celebrate success!

These goals become the guide posts for an EHR implementation project, and achieving these goals will motivate providers and practice staff to make necessary changes and attain new skills.

Critical outcomes of the assessment process include:

  • A designated leadership team for the EHR implementation process (clinical and practice management staff, or for small practices, the entire team). Having strong and positive advocate(s) for change can be one of the strongest tools to guide the transition.
  • A unified vision, where each member of the practice team understands how they will be affected by the change and understands the roadmap to success.
  • Measureable, quantifiable, realistic goals, which are the key to the assessment phase

National Learning Consortium Resources

Over the coming months, the NLC will continue to share experiences from the field and the resulting leading practices and tools that can be used throughout all phases of the EHR Implementation Lifecycle. Please check back often for updates.

Learn more about the The National Learning Consortium >

The material in these guides and tools was developed from the experiences of Regional Extension Center staff in the performance of technical support and EHR implementation assistance to primary care providers. The information contained in this guide is not intended to serve as legal advice nor should it substitute for legal counsel. The guide is not exhaustive, and readers are encouraged to seek additional detailed technical guidance to supplement the information contained herein.

Reference in this web site to any specific resources, tools, products, process, service, manufacturer, or company does not constitute its endorsement or recommendation by the U.S. Government or the U.S. Department of Health and Human Services.

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Creating a Leadership Team for Successful EHR Implementation View
Change Management in EHR Implementation View