EHR Implementation Requires Ongoing Vendor Communication

Congratulations, your medical practice has selected an EHR after months of deliberation, budget considerations, and vendor demonstrations. Now comes the easy part, right?

Not quite. Making sure that the product is a good fit for your medical practice means a well-defined and thought-out implementation process - and that means maintaining close ties and constant communication with your vendor.

Lil Sonntag, health IT consultant and project manager at Aurora-based Colorado Rural Health Center, advises practices to ask a lot of questions during their initial EHR implementation.

"If the vendor doesn't take the bull by the horns and initiate an implementation timeline, you should ask for one with dates of expected completion," she said.

Some questions Sonntag suggests practices ask include:

• Do I have to buy hardware?

• Do I need to have the hardware installed?

• Who installs that hardware?

• Where does the patient portal fit into this?

• How about training?

• Who's my contact person?

In smaller practices, people are wearing a lot of different hats. "You want to have an idea of who you have to talk to [at the vendor] in case an employee [from your practice] leaves," said Sonntag, who recommends posting a document on the wall of the practice that includes implementation timelines and the names of vendor contact people and their bosses.

"If you start relying on the vendor to complete [its] project, it may become a very long, frustrating implementation," said Sonntag.

She also cautions practices to be very careful to ensure that their vendors are really educated about CMS' meaningful use program. "Not a lot of vendors are meaningful use experts," she said. "Time and again, they don't know the truth about a certain objective."

Maintaining support

After the EHR go-live stage, the practice will be transitioned over to the vendor's support team if there are problems.

"Once that initial go-live period ends, your boat is in the water and you're pushed off [the] shore," said Derek Kosiorek, principal consultant with the Medical Group Management Association's Healthcare Consulting Group.

Successful practices have one person or a small team focused on being the "owner" of the EHR system, said Kosiorek. This is good for the practice because it prevents multiple avenues of communication between the practice and the vendor, and it also streamlines things for the EHR vendor. That single point of contact or small group at your practice can coordinate how well the system is doing and can understand the challenges the practice is experiencing.

Once a practice has established this communication relationship, it's good to have an understanding of the EHR vendor's plan for future enhancements and upgrades. Kosiorek said that most vendors should know their development cycle for the next release or two.

"This is especially important with meaningful use changes," he said. "You have to know [the vendor's] plan. I just read in [the proposed rule for] Stage 3 that you need to be able to interface with patient-generated data. Vendors have a lot of work to do now to get that information to the federal government. You need to know that they have that on their minds, and when they're going to release that update to your practice."

Kosiorek also recommended practices set up an e-mail address for doctors who want to provide feedback on the EHR. This is helpful as the single point of contact or small team responsible for the EHR considers changes to the system over time.