by Brett Preston.
Implementing new software in a clinical setting is tricky for a lot of reasons. Whether you are in the market for a new EHR, a new billing tool, or a quality reporting system you should pay special attention to these details early in the project:
- Existing workflows – Existing workflows are often based on antiquated processes that have grown and developed over time. A lot of research might be required to determine the current workflows and how much they can be revised to fit with a new software tool. This may require many meetings with end-users, or creating workflow diagrams.
- Legal requirements – In healthcare there are many requirements that need to be met when implementing new technology. These requirements relate to patient information, security, privacy and billing and quality data. Some examples are:
- Patient information (HIPAA and HITECH)
- Clinical documentation (TJC, AABB and specialty organizations)
- Billing data (Medicare and private insurance claim submission requirements)
- Quality data (PQRS and quality registries)
If you do not have a complete picture of all of the requirements and how to meet them, you will either have to add additional staff (ie – quality staff to comb thru charts and retrieve data) or add additional steps to the provider’s workflows. Both of these will result in an increase in HR costs and can be avoided by understanding legal requirements.
- Usability for clinical staff – Clinical staff are, and should be, focused on patient care and clinical communication, not necessarily technology. Due to the complexity of the requirements, care providers will need to enter very specific information in a very specific way. It is very easy to overbuild your system, which will create an increase in workload for clinicians resulting in frustration and resentment. If you have done a good job of determining workflows and understanding requirements you should be able to build a system that is streamlined as well as usable and compliant.
- Hardware – You will need to spend some time to ensure that you have the correct devices (laptop, tablet, rolling cart, etc.) in the correct locations. Without access to hardware, staff will be unable to complete the required documentation at the correct times. This will result in poor and missed documentation. In your search for perfect hardware you will come across many constraints – budget, space, and connectivity to name a few. You will need to make sure that you get sign off from your end-users on the hardware that you put in place to prevent expensive and time-consuming re-work.
- Integration – In a clinical setting it is often not possible to find one system that can meet all needs and all requirements. This will mean that you will have multiple systems and you will have to send or receive data between them. For example, sending your patient list to your lab system, or your surgery schedule to your quality system. A system that allows for easy integration with other systems can prevent expensive technical support or hours of manual re-entry.
- Reporting – Once you have a system built and in use, you will have data for reporting. The more thought you give to reports earlier in the project the better off you will be. Does your billing department need specific data to submit claims? Does your finance department need information for dashboards and trending? Does your quality department need clinical data and outcomes data for quality improvement initiatives? Thinking about these types of questions will allow you to build a system that makes reporting easy. Many systems come with a built-in dashboard functionality that will allow you to run standard KPI reports to help drive your business.
While there are hundreds of factors to be considered when implementing a new technology in a clinical setting, paying special attention to these elements early in the project will help save time and money throughout the course of the implementation.
Brett Preston is EMP’s Director of HIT Security and Management.