At some point in your practice’s lifecycle, you may find the need to replace your current Electronic Health Record (EHR) system. Your system could be outdated, badly suited for your practice, or just have an unresponsive and unhelpful vendor. In any case, transitioning from one EHR to another is stressful, costly, and highly disruptive, and can lead to physician and staff burnout during and after the process.
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When to Switch an EHR
You may consider switching to a new vendor in a number of scenarios, including:
- Your current vendor has not developed functionality to comply with newer regulations and quality reporting
- High operational costs or undisclosed additional costs
- Lack of customizations needed for your specific patient services
- Dissatisfactory system functionality and services
- Security failures or threats with serious consequences for organization and patients
- Discontinued support for your specific specialty
- Significantly increased prices with renewed contract
- Failure to fulfill and EHR’s purpose, i.e., to reduce physician workload
- New practice services that the current EHR does not support yet
EHR-Related Stress in Clinicians
Research has now established a link between EHR-related stress and burnout – and there is no denying that transitioning to a new system is stressful. A study carried out on registered nurses studied three independent variables: time spent on the EHR, daily frustration related to the EMR software, and time taken for documentation. It revealed that 20% participants experienced at least one symptom of burnout, while 50% strongly agreed that their EHR contributes to their daily frustration. Another research by Brown University surveyed all physicians in the state and found out that 70% reported health IT-related stress, while 25% directly reported burnout.
EHR Transition and Clinician Burnout
During EHR transition, there are several factors that contribute to stress.
- Costly process; purchasing, training, hiring external resources, and system conversion
- Clinical risks, since access to patient data and business records is disrupted
- Data migration may be incomplete, depending on both vendors
- Time taken by staff and physicians to learn the new system
- Staff and/or stakeholder resistance, since some may face difficulty with change
- Lack of productivity, workflow efficiency, and number of patients seen
- Incomplete implementation or lack of adoption of the new system
Tips to Ensure a Smooth EHR Transition
In order to make the transition easy, effective, and stress-free, and ensure that clinical staff doesn’t undergo burnout, it is essential for physicians to assume a leadership role in the process.
Create an engagement and training plan
It is recommended that physicians involve their clinical staff in the EMR software selection process since the very beginning, since this will make them feel like they are a part of the process, and not merely being forced to adopt a new system. Inform them of the decision to replace the EHR as early as possible, discuss the options, and also take their feedback about what the previous system lacks and what is needed in a new EHR. The physicians working in the practice should also be actively involved in the decision-making process, especially with regards to clinical workflows, interface, quality improvement, customization options, etc.
Find an EHR that meets your specific needs and growth plan
Research has revealed that independent practices are now likely to switch their EHR if it fails to provide quick ROI. This means that you need to look for a system that provides high functionality and efficient workflows, by meeting your physicians’ needs and your practice growth plans. Shortlist the most suitable EHRs, consider where you want a cloud-based or on-premises system, evaluate the prices and features, set up demos, and connect with current clients before making a decision. Remember that choosing the right system that requires the minimal time spent on screens will reduce the burden on the staff.
Make data migration a priority
Perhaps the most stressful part of an EHR transition is ensuring that all patient data is successfully transferred to the new system, or otherwise stored if full migration is not possible depending on the EHR vendors. To avoid challenges in the process:
- Connect with the old and the new EHR vendors about data transition and mapping costs
- Anticipate data mapping needs
- Thoroughly plan the transfer into the structured fields in the new EHR
- Use continuity of care documentation (CCD) to accurately read the exchanged data
Create a transition timeline
With a timeline and all tasks in place, clinical staff will know what to expect, which itself reduces the possibility of burnout that comes with unexpected burden and stress. A good EHR system should take merely weeks to implement, but could take a few months depending on data migration and other individual practice requirements. Ideally, you should accomplish tasks in the following order leading up to the launch of the new EHR:
- Communicate with staff, create a vendor list, attend product demos
- Evaluate staff readiness through meetings and surveys
- Set a timeline for implementation and staff and physician training
- Appoint an internal EHR transition team, define roles, plan data mapping and new workflows
- Work with the old vendor to secure your patient data and other medical archives
- Test the new interface and workflows, transfer patient records
- Customize new templates according to your practice, recheck workflows
- Get regular staff feedback on the process before the final launch
- A few weeks following the transition, follow up with staff for any concerns and contact the new vendor for improvements or customizations needed
While replacing your EHR is not an easy task and can overwhelm clinical staff as well as physicians, the right system implemented following the right process will ensure that the benefits it provides will compensate for the time and money spent to acquire it.