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How healthcare organizations can learn from their implementation efforts
Implementing an electronic health record is a complex process, one that’s difficult to get right. It’s also a long process that offers opportunities to take knowledge learned during the process to use it for current or future projects. Hayes Management Consultants suggests healthcare organizations can learn from their experiences during implementations to fill in gaps in functionality and optimize the EHR on the fly.

Hayes suggests that with planning and foresight, healthcare organizations can capture working knowledge in a “lessons learned” document that can help them make the leap from a merely functional EHR to a fully optimized one. Hayes research suggests that 73 percent of EHR implementations fail, demonstrating the importance of learning throughout the implementation process. Here are the steps to follow.
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The overall strategy to optimization
EHRs should help achieve clinical optimization, which improves patient care through better system utilization, efficient work processes and better training of staff. The purposes behind this effort are to better meet regulatory requirements, increase the ROI on a technology investment, and provide higher quality, cost-effective care. In this continuous quality improvement process, key ingredients are evaluating and educating staff; reviewing and improving workflows; and analyzing and leveraging EHR capabilities. Toward these ends, documentation of the process is key.
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1. Plan to gather and use lessons
Unless an organization intentionally decides to gather the lessons learned from an implementation, they won’t provide any value-added to the ongoing phases of a project. “This is especially important in projects with continuous rollouts to multiple facilities using a ‘standard’ EHR product,” according to Hayes.

A “lessons learned” collection and documentation are normally defined deliverables of any managed project.
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2. Train staff to document the process
From the beginning of the project, train staff to develop a living, ongoing document of hiccups, processes that could be expedited, or mistakes that could be avoided in the future.
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3. Don’t just file away the findings
In many projects, lessons learned are only seen as part of the closing phase of a project. They’re collected and documented, and then often times filed away and never reconsidered. But to gain real advantages from the lessons, they must be used on an ongoing basis to optimize future or current projects, to reduce redundant work, and save time, money and resources.
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4. Require clear communication among team members
Ensure that an implementation team understands and knows how to identify important lessons and why they’re so important to the organization. “Too often, smaller details fall to the wayside during project implementation because team members don’t understand how important the little things can be and how they can be leveraged in the future,” Hayes says in its research.

It’s more than just identifying what isn’t working or outlining the negatives of the project—it also important to highlight what’s worked and should be duplicated in the future to meet organizational goals. “The document should be considered a continuous quality improvement tool,” Hayes says.
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5. Establish ownership of the process and delegate responsibility
Those in charge of an implementation must decide who will be responsible for the ongoing process of gathering information and documentation. Leaders should assign a key team member as the keeper of the “lessons learned” document. Delegating a single owner or keeper of the document also eliminates confusion over who is responsible for data gathering and gives everyone a “go-to” person whenever a new lesson is learned.
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6. Set the scope of information to be gathered
Information should be collected not only from the project team, but from all teams, stakeholders and subject matter experts connected to a project. “Involving all relevant parties ensures a collaborative and thorough effort to collect the information and fosters a sense of ownership over the process and project,” Hayes says.
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7. Have clear requirements
The implementation team and its leaders should specifically define the parameters around lessons learned, including when they should be collected, how they are to be documented and who bears the responsibility for periodically reviewing them.

“Because lessons learned are part of quality improvement, they should be viewed as an integral process throughout the entire lifecycle of a project,” Hayes says. “They should be finalized at the close, and reviewed at the beginning and during any subsequent project. Clearly define the requirements for including events in the document, ensure that everyone is contributing and collectively establish milestone review points.”
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8. Be militant about studying the lessons
The process of documentation is helpful. But to truly optimize an EHR implementation, it’s crucial to refer again and again to the ‘lessons learned’ document. “Through constant evaluation, you will ensure that the best practices have been saved and future projects will benefit from the most important lessons learned,” Hayes concludes.