Community Connect: 7 Wrong Turns to Avoid

By: Nikki Chapman, ICG Epic Consultant

Extending your organization’s EMR to community physicians and hospitals can prove to be life saving for the patients of your community.

This, in turn, dramatically increases patient safety and continuity of care. Sharing known allergies, current medications, and saving time on reviewing lab and radiology results are all examples of how a patient’s healthcare can be greatly affected.

Your organization has decided to increase the footprint within the community by offering availability to your EMR.

Now what?

The first steps in developing the program can feel a bit daunting to those involved. It may feel like setting off on a road trip without a map or a compass or a smart phone. These days many of us would be completely lost without these tools to guide us. In planning a road trip, typically, milestones are planned along the way to the final destination. Having a clear vision of the whole picture will help you and your organization to determine the milestones and plan for success.

The healthcare community is a small one within every region. And when things go well, it will be talked about. However, if a go-live turns south, the word spreads like wildfire within the local healthcare community, potentially harming the success of your organization’s program. Here are a few wrong turns to avoid in helping to ensure a successful program.

1. Navigating without a compass.

When starting a connect program, develop a strong steering committee that knows and is behind the overall strategy. Develop a roadmap of healthcare sites that will be successful and have similar goals to your organization. Determine those sites by considering the following:

  • Financial stability – a thriving practice usually reflects the success of the practice.
  • Similar goals and standards to your organization – a practice that aligns similar to your organization will ensure a cleaner patient record.
  • Amount of referrals to and from your organization – the amount of the referrals between your organization and the potential site can indicate a larger common patient base, affecting a greater patient population.

2. Fast and furious.

Understand the time requirements of the development of the contract and all third part contracts prior to scheduling your first go-live. Generally, the development of the contract between your organization and your customer takes 6-9 months. And that’s being generous. Before the finalization of the contract many decisions have to be made, such as: what will the package offered include, negation of third party contracts for additional licensing, service level agreements, etc. Additionally, your legal team will want and need to be involved to fully understand what is being offered, how Stark laws can effect the contract, and the agreements for allowing users outside of your organization to use the system. Having a plan to potentially separate from a potential client is also a necessity within the contract.

3. Selecting a model, including add-ons, options, and fine print.

Developing a solid and clear marketing package will help to set expectations from the beginning. During the initial conversations, it is vital for the package and its contents established. Clearly communicate what is included with the actual implementation of their site and what is a chargeable add-on. For example, custom reports or custom build that can take costly resources can potentially be an add-on package with a set price. Having a clear understanding for both your organization and your potential client will help to provide a solid foundation of the relationship.

4. Avoid sticker shock.

Be clear about what goes into the pricing that is presented in the contract. When developing the pricing portion of the contract, break down what’s included, such as training, go-live support, and help desk for post-go-live process.

5. The vehicle has all the bells and whistles, but no gas in the tank.

There are two parts to this potential blunder to consider. First consider the state of your current infrastructure and setting expectations of what is required for hardware/software/connectivity for your future customer. A full evaluation of your current state of your organization’s infrastructure is a valuable tool to help develop the costs and plan to fill any necessary gaps to accommodate the additional usage of the system. This also applies to interfaces that will potentially be used for these sites. Another consideration is setting requirements for hardware and software for the incoming customers.

6. Giving an inadequately educated driver the keys.

There are many options for how to provide education to your in-coming customers, and knowing them may determine the success of your go-live. Some organizations choose web-based training, some classroom training, and some a mixture. Knowing your clientele can help you make this decision. If your organization is looking to bring on smaller ambulatory clinics, they may not have the resources to attend 20+ hours of training. Providing the intro related workflows via the web-based training and offering minimized classroom training may be a good alternative for your organization. If your organization can only offer web-based training, consider providing the practice environment an extended go-live support to accommodate the needs of your soon-to-be customer.

7. Caution: OVERLOAD.

When development of the overall strategy is taking place, consider the amount of resources required to make your strategy a success. Your timeline may include several back-to-back implementations. Consider a team large enough to rotate the discovery, data collection, build, and go-live duties. The question is: to have a separate build team or envelope it into the current build team? The timing of your project plan in conjunction with other organizational initiatives will play a part in how to proceed. If there are other large projects or your organization is new to the system themselves, then it might not be feasible for the current staff to take on. Consider forming a team specific to this project with members being liaisons to the project team. Extending your organization’s EMR generally is a long-term initiative and often includes time away from the office for discovery, meetings, go-live prep, and go-live support.

Being successful is not only important to your organization, but also to your customers and most importantly, the patients. While there are many opportunities for failure, there are also many opportunities for success when it comes to extending your EMR. A solid roadmap (clear strategy), a navigation system (project plan), and clear communication will help to build a solid roadmap, guiding your organization to its destination, with the windows down, the radio up, and singing at the top of the lungs.