Managing an EHR Upgrade: Recommendations

While on the surface upgrading to a new version of an EHR may sound straight forward, they tend to be very complex. They require communication across many functional areas, retesting all integration points and meeting milestone date. In this blog, we will discuss some of upgrade experiences and provide a few recommendations.

The first recommendation is to work with your vendor to really understand what is required to

complete an upgrade from their perspective, keeping in mind you need to understand and manage the operational impact of the upgrade typically without the assistance of the vendor. The best place to start is to review the contract internally, gather a list of questions and then review with the vendor. Often contracts are vague, leaving room for interpretation. You should work through the gray areas with your vendor during a contract review session.

A few suggestions when reviewing the contract:

  • Scope should include all your core application modules,interfaces, and integration with third party vendors.

  • Review the timeline and the resource requirements. Discuss the impact to these constraints if a milestone date slips or an accelerated or extended time frame is desired.

  • Verify that that any vendor or third party customizations will be compatible with the new version to avoid undesired surprises.

  • Verify that all third party integration will work successfully with the new version.

  • Confirm whether any additional services are truly needed.

The second recommendation is to ask the vendor to confirm they can implement and deliver in your time frame. The vendor will have upgrade dates that are dictated by their resource constraints. Vendors may also have contracted for an upgrade that has not been officially released. Also verify that the version that you are upgrading to contains all the enhancements your organization expects.

Here are a few questions to get you started:

  1. Have you successfully upgraded any other clients on my current version of the software?

  • Get a reference site and call them to discuss their experience and challenges directly.

  1. We are trying to accomplish X with this next version of the software, will we need to install any additional updates/patches after the upgrade to accomplish our goals?

  2. What go live dates are available at this time?

  3. How many clients are contracted to upgrade in the same timeframe?

The third recommendation is to request an implementation methodology review session before the project kick off. You will not need the entire upgrade team involved in this process but recommend managers from each group join this discussion. This will allow your organization to understand the resources required, the roles of these resources, the phases of the project, duration of each phase and the milestones within each phase. If your organization has a timeline constraint, it is essential that you set a go live date and work the dates backward to understand when you need to complete each phase.

The last recommendation is to ensure that you fully understand the operational impact of an upgrade. You’ll need to consider the amount of retraining that is required to take full advantage of the software upgrade enhancements. This is likely to be a substantial effort to communicate the training requirements to all users, set up the training scenarios, and also figuring out the logistics on where the training will be conducted. The other aspect is supporting the upgrade go live. It is essential that the level one support staff is fully trained on the enhancements to the applications in order to be prepared for the increase activity. There will be a percentage of tickets that come in after the upgrade go live that are related to the new functionality and the system is actually working as designed. Your support team needs to fully understand how the enhancements affect the user’s workflows.

In closing, an upgrade requires a tremendous amount of effort and coordination by both your organization and the vendor. The best advice I could give is to communicate your needs/constraints with the vendor and work with your vendor to mutually agree on a strategy to meet your goals. We are not talking about a simple Windows update; it will have a large impact on your organization and should be given the attention it requires to be successful.

#EHR #EHRAdoption #ChangeManagement #CPOE

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