Ongoing Engagement Critical To EHR Success

Too many organizations focus on the initial implementation of an EHR and too few spend enough time on sustaining successful adoption and use of the system over the long term.

That's, according to Heather Haugen, senior vice president of research at the Breakaway Group during a session at the 2015 Healthcare Information Management and Systems Society (HIMSS) Annual Conference.

"Sometimes we get caught up in the wedding and forget the marriage," said Haugen. She explained that organizations will spend years preparing for the "go-live event," but afterwards don't put in the continued effort needed for success.

As a result, many organizations implement EHR systems but never get the value they were hoping for. Research by Haugen and her Breakaway colleagues that included interviews with more than 3,000 clinicians and executives found four keys to successful adoption of an EHR: engaged leadership, efficient and effective training, data sharing, and sustained efforts to support adoption.

Engaged Leadership
First and foremost, she said it is necessary for practice leadership to be focused and actively engaged in the process of adopting an EHR. Too often, she said competing priorities cause executives not to be engaged.

"If an EHR adoption is not in your top three priorities [as a practice] it is very hard to get it done," she said. "As leaders, we should ask: What are the things we are going to stop doing to do other things well?"

Efficient and Effective Training

The next key is how quickly the organization is able to get its staff proficient in using the new system to provide care. Haugen said it is important for training to be provided in "bite-sized" time periods and as close to implementation as possible.

"Time may be the most precious asset to any clinician," she said.

Training should ideally focus on realistic simulations that help walk clinicians and staff through the specific tasks they will be using the EHR for, she said. It should not spend a lot of time detailing the various features of the EHR.

"The clinicians don't care [about functions], they want to provide care," she said.

Organizations should also test staff to assess their proficiency at using the application, and leaders should observe the use of the EHR in action to identify what's not working well in order to address corrective measures.

Data Sharing
Another key is early and frequent use and sharing of data from the system. Haugen explained that the first thing that practices and hospitals should measure is how proficiently staff is using the EHR. Otherwise, any data may be inaccurate. Next, they should focus on a few data areas and share that information with their clinicians to help them improve care.

She said that physicians are naturally analytical, so having data will inspire them to look for ways to improve care and will help them see value in using the EHR efficiently.

Supporting EHR Adoption
The final key is ongoing leadership and continued efforts to maximize adoption of the EHR over its lifespan. Haugen said many organizations assume that they are proficient years after an application has been installed. However, proficiency can fall off over time if new employees aren't trained well and staff share work flow workarounds. Additionally, someone needs to be in charge of preparing staff for upgrades and training incoming staff.

"You have to stay engaged for the life of the application," she said.