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Transitioning from an Electronic Health Record (EHR) software to a new one is a decision that must be taken considering all the operational and financial aspects that this entails, as well as the roles and workflows of users that use it.
The final decision to change the EHR must be made after an exhaustive analysis of factors that generate this scenario, as well as a foresight of the challenges that must be resolved along the way and, above all, always keeping an eye on the benefits that this will bring, such as greater operational efficiency, an increase in staff satisfaction and an improvement in the patient safety.
Reasons for changing EHR provider
▪️️ The EHR provider significantly increased prices when renewing the contract.
▪️️ Extra costs are incurred to obtain all the functionalities of the system.
▪️️ The software can't be adapted to new hospital workflows.
▪️️ The provider did not develop improvements that allow hospitals to address new health regulations.
▪️️ The support team does not answer questions or fix errors.
▪️️ The provider was responsible for a security breach.
According to a survey responded by 305 participants who were involved in the transition from one electronic health record software to another, the main reason an institution makes this move is the need for new functionalities to continue or improve the operations. Complying with sector standards, better usability and a better support and training team were the following reasons, in that order, for the software change.
Starting the EHR transition
The executive and clinical team expect significant obstacles when moving to another Electronic Health Record software, going from an expensive process to the risk of losing partial or total information from records. While this change is not a new practice, applying a perfect standard for all experiences is impossible since each hospital's operation and software scope is unique.
The article "Practices Supporting Electronic Health Record Transitions: Lessons from Four US Healthcare Systems" tells the experience of people changing electronic health record software in different hospitals in the United States, separating the process into three stages.
Before go-live
▪️️ Communication with the teams involved is vital. The publication states that some respondents criticized the move since they lacked an understanding of this decision. Also, internal messages should consider new system-specific tasks and create realistic expectations.
▪️️ Understanding of existing workflows. The importance of developing a detailed knowledge of the organization's foundations to plan changes during the EHR transition is highlighted. The best strategy is the involvement of interested parties to understand the workflows and take advantage of the situation to reassess and eliminate inefficiencies.
▪️️ Plan the scope and appropriate customization. This point seeks to align the hospital's expectations with the provider's deliverables from the beginning to work under the same objectives and limit redundancies.
During the go-live
▪️️ Customization of training and support. A critical point during the implementation was the training of the next users. One respondent stated that sitting and listening to trainers explain options was inefficient instead of recreating supervised situations.
▪️️ Strengthening internal support. Identify influential "superusers" who can provide support during the EHR transition.
▪️️ Reduction of workloads. During implementation, it is recommended to eliminate extra work-related stressors and reduce clinical capacity as much as possible during the transition.
After the go-live
▪️ Continue investing in change. Continued support and training after the first few weeks of implementation are essential. The team must commit to continuing to optimize the system.
Challenges encountered in the process
After the hospital EHR software transition, the people involved reported:
▪️️ 59% agreed that the new system provides useful new functionality.
▪️️ 43% feel content to have changed their electronic medical record system.
▪️️ 42% said they had a better support and training team
▪️️ 41% considered the newly acquired EHR "is not too complex to use."
▪️️ Only 39% said they were content with their new EHR.
▪️️ Of the 140 respondents who said they were involved in the decision to change systems, 61% are happy with their new EHR, compared to 19% who felt the same positive but were not involved in the decision.
The transition from electronic medical records software for hospitals represents a unique journey. Although the points indicated can serve as a guide, it will depend entirely on the hospital team's relationship with the new service provider.
Sources:
▪️️ Healthit.gov
▪️️ Aapf.org
▪️️ Rinne, S. T., Brunner, J., Mohr, D. C., Bearak, A. C., & Anderson, E. (2023). Practices Supporting Electronic Health Record Transitions: Lessons from Four US Healthcare Systems. Journal of general internal medicine, 38(Suppl 4), 1015–1022. https://doi.org/10.1007/s11606-023-08279-0
