Read this if you are considering a system implementation for Electronic Health Records (EHR) or other systems.
EHR go-lives are often years in the making, from the initial process of vendor selection to system implementation and finally launching the system. Achieving go-live is a significant accomplishment and an essential milestone on the path to success for your healthcare system.
Most successful go-lives have a detailed wave master, project plan, and cutover plan covering everything from who will offer to be “at-the-elbow” support for launch, to parking lot procedures for vendors, to food plans to keep your team nourished. An important area that can sometimes be overlooked during go-live preparations is the front of the house, specifically the patient access area (e.g., registration).
Anyone who has visited a busy restaurant or watched competitive cooking shows such as Top Chef will understand the importance of a well-managed front of the house. No matter how amazing the food is, a long wait, poor customer service, or disorganization can ruin the entire dining experience. Similar to a kitchen, high-quality radiology, laboratory, or surgical departments can be thrown into chaos by inadequate patient access throughput at go-live.
During various go-lives, we have seen 90-minute patient wait times in the patient access area, causing angry patients and downstream problems with clinical care and frustrated departments. This image is not what you want your patients and community to picture when thinking about your new multi-million-dollar EHR system. You spent months communicating that the new system was coming, letting patients know what to expect, and promoting the benefits. Don’t let the first impression they have be one of frustration and problems.
Considerations for EHR system go-live success
To help you create an effective and smooth-running front of house during go-live, here are some items to consider:
Leader at the front
Much like a good front of house manager can make the difference between a successful vs. failing restaurant, assigning a strong leader to serve in a similar role during go-live can make a big difference. Asking someone from your leadership team to park themselves in the patient waiting area to monitor for bottlenecks, resolve problems, exude excellent customer service, answer questions, and perhaps even push around a coffee cart, can be helpful. During go-live, your patient access staff may be fully occupied with their tasks and may not have the capacity to notice any issues arising or the power to gather the necessary resources for resolving problems, so adding a leader solely dedicated to monitoring the front of house can be invaluable.
Training and practice
Operational efficiency is the name of the game at the registration desk. A new EHR has the potential to disrupt the workflows that the staff once had with the old system. The old system may not have been any good, but your registration team knew it inside and out. They knew the buttons and terms, and they knew how to fix and work around its issues. That all gets changed with the new EHR. Registration staff can benefit greatly from education, hands-on training, and access to resources such as standard operating procedures and quick references. Additionally, allowing for extra practice time can help ensure a successful go-live.
Over staff
Even in the face of staffing challenges, consider overstaffing for the first week of go-live. Calling in a per diem or part-time patient access person to increase capacity will compensate for any slowness while your staff put their EHR practice into play.
Super-user at the elbow
Having a strong super-user at the patient access teams’ elbow can be immensely helpful. That person can float amongst the team, answer questions, assist them through the new workflows, and communicate build issues to the command center. The super user helps the team feel supported and confident and better able to provide the best patient customer service.
Pre-registration calls
With all the activities leading up to the go-live for the new system, it can be easy to lose sight of your daily operations. If pre-registration calls are a common practice for your organization, you are normally multiple days ahead of the date of the visit. If your implementation has caused you to fall behind, it will only compound the problem during go-live. Maintaining or even exceeding your typical operations before going live will help create a smooth transition.
Laminated cards
During go-live, you may need to ask patients to answer questions, scan their insurance cards, and review documentation. Established and regular patients of your health system may wonder why you're asking for this information again. When patients or family members are not ready for the new registration process, this slows down the whole process. Having laminated cards explaining that a new EHR has gone live, the documents the patient should have ready, and the types of questions you will need to cover will help patients be more prepared and understand what to expect when they arrive at your patient access desk.
No maintenance window
This may sound silly but let your maintenance team know the go-live date and that no work should be done that limits the number of patient access desks available to staff. A smooth process is all about maximizing throughput. If planned maintenance reduces the number of teammates who can see patients, it will create an operational bottleneck on an already challenging week.
Customer appreciation set up
Inevitably there will be some patient or family frustration no matter how well you plan and execute your plan. Having a proactive customer appreciation set up in advance (such as a free coffee) and reactive customer recovery kits (such as gas cards, free lunch cards, etc.) on the ready will help your team manage through the new process and assist in creating a positive customer experience.
Much like the front of the house in a restaurant, the registration area is where patients gather, first impressions are made, and frustrations can build, all before they get to the purpose of why they visited you to begin with: receiving care. Focusing on readiness, providing leadership, communicating clearly, and optimizing the go-live process will help you increase the likelihood of success.