Healthrise Identifies Key EHR Go-Live Readiness Factors

A go-live rarely announces that it’s in trouble. It usually starts quietly with a user who can’t log in. A registrar cannot access the tools needed to check in a patient. A nurse is unsure who owns the next step in a new workflow. A physician cannot find information from the legacy system. A payer issue that seemed minor during testing later contributes to a denied claim. Individually, these may look like isolated issues. Together, they can reveal a larger problem: The organization was prepared to launch the technology, but not necessarily prepared to operate differently.

According to Healthrise, a health care consulting and technology firm, that distinction is at the heart of operational readiness. While implementation teams focus on building, testing and deploying the system, health systems also must prepare for the decisions, handoffs and workflow changes that begin once the system is live.

The Decisions Behind the System

Health systems can spend years preparing for an EHR transition, yet the operational impact can accelerate dramatically in the final months. Teams are making decisions about system settings, workflow design, legacy accounts, staffing and access, often while managing their existing responsibilities.

According to Woodley, decision-making capacity is one of the most underestimated resources during an implementation.

Healthrise recommends beginning operational readiness work as early as 18 months before go-live to identify where decisions are accumulating, ownership is unclear or workflow changes could create downstream consequences.

The Cross-Functional Handoffs

The most revealing readiness exercises are not necessarily the ones that test whether an employee can perform a single task in the new system. They are the scenarios that force multiple teams to work together. Healthrise recommends using day-in-the-life scenarios, preparation labs and integrated tabletop exercises to recreate situations employees will encounter after go-live. The goal is to determine whether people know what happens next, who owns the next step and how to recover when something goes wrong.

The Final 90 to 180 Days Before Launch

The final 90 to 180 days before launch can serve as a critical stress test. Health systems should validate access and staffing models, test integrated workflows with actual end users and identify where work changes hands between departments.

What Week One Reveals

No go-live is completely free of issues. The difference is often how quickly an organization can identify, route and resolve them. In the first week, Healthrise recommends watching workflow ownership and integrated processes closely. Do employees know who owns the step before them? Do they know where to take an issue when something goes wrong? Can departments resolve problems directly, or do issues repeatedly move up the leadership chain?

These gaps can surface as patient delays, employee frustration, registration errors, denials and other downstream problems.

Go-Live Is Not the Finish Line

Readiness also should extend beyond launch. Healthrise recommends defining post-live optimization priorities before go-live, including what the organization wants the EHR to accomplish and what success should look like 12 to 18 months later.

Some organizations may need to stabilize core workflows before adding complexity. Others may be prepared to implement more capabilities immediately. The key is making that decision intentionally and understanding the tradeoffs.

Ultimately, the question is not whether an EHR can be configured, tested and turned on. It is whether an organization can make decisions, connect workflows and respond to problems when the technology becomes part of everyday patient care.

"Go-live is not the finish line," Woodley said.

For health systems preparing for an EHR transition, that work starts long before the first patient arrives. The strongest readiness strategies account not only for what the technology can do, but for how people will make decisions, work across boundaries and adapt when the reality of go-live does not perfectly match the plan.

To learn more about EHR go-live readiness and Healthrise’s approach to helping health systems prepare for a smoother transition, visit www.healthrise.com.

Healthrise is a healthcare consulting and technology firm that provides revenue cycle management, electronic health record optimization and strategic advisory services to hospitals and health systems across the United States. Founded in 2012, the company partners with organizations to improve financial and operational performance through customized, data-driven solutions.