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As hospitals and health systems prepare to implement electronic health records (EHRs), they can ensure a smooth transition by identifying potential pitfalls and taking steps to circumvent them during the period after the new system goes live.
Over the seven years since the American Recovery and Reinvestment Act established incentives for adopting and using qualified EHRs, the healthcare industry has witnessed poorly implemented EHRs lay waste to revenue cycle performance metrics, with examples including gross revenue losses, spikes in accounts receivable (A/R) days, and steep declines in cash flow. Meanwhile, health systems that are preparing for in the early stages of an EHR implementation are just beginning to confront the unfamiliar risks of such projects, including management of multiple financial systems, siloed organizational structures, cultural barriers to change, and end-user acceptance.
Health systems grope for elusive ROI from EHR implementations at the same time they face growing clinical and financial pressure to achieve the meaningful use these systems promise. The good news is that, with proper preparation and conversion management, they can achieve or even exceed these metrics. To ensure a smooth implementation, health systems should adopt a three-pronged strategy: preparation, risk mitigation, and optimization.
OhioHealth, a io-hospital system serving the greater Columbus, Ohio, area, achieved strong results by adopting such a strategy throughout its 15-month EHR implementation.
Pre-Live Preparation
Thorough planning is essential when undertaking an EHR implementation. This process, consisting of the following two broad steps, could take a health system a year or more to complete.
Assess the current state and future system workflows. If the health system is a leader in revenue cycle performance, maintaining core metrics likely will be a priority. In assessing the policies and procedures currently in place, health systems can identify how to close gaps between the status quo and best practice recommendations, taking into account those areas likely to change due to the implementation. Key questions include:
> Who are the key stakeholder groups for the workflow design-build validation sessions and for testing scope and execution? Here, it is critical to understand how the health system's workflows interconnect (e.g., how patient access workflows affect clinical workflows, and how the latter, in turn, affect billing office workflows) so that all appropriate departments are represented.
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