It’s very difficult to hit a moving target; even more so if that target isn’t easy to spot. If you dive into an EHR project without a clear sense of where you want to go and what it’s going to take to get there, you’re flying blind. Your budgeting is unlikely to be meaningful, and your target roll-out date might come and go while you work to get things back on track.
Successful electronic health records (EHR) projects are contingent upon effective planning throughout the process, and accurate scoping during the project’s initial phase can help make goals clear. It also helps give project leaders a better understanding of possible challenges, from clinical resistance to potential budget overruns, and can avoided both spiraling budgets and end-user frustration.
Here are four common mistakes to avoid in scoping out a project:
#1: Underestimating the Contract
Developing a thorough understanding of the intricacies of an EHR vendor contract is an important first step towards a successful project outcome; nevertheless, many organizations fail to determine what’s covered and what’s not. It’s essential to have a clear understanding of the full extent of your platform vendor’s responsibilities. Working off assumptions can lead to a scramble down the line.
It can be critical to try and identify additional, undisclosed costs. For example a vendor may offer a discount on a particular product, but the discounted product may only work in conjunction with other full-price products which are not included in the deal. Being aware of how new software will integrate with your existing systems and devices can help to prepare you to evaluate the contract thoroughly. It’s also to your advantage to be sure you have an explicit understanding with your vendor about the necessary volume and expected quality of any build work that is being outsourced.
You should have a good grasp on the current state of your IT environment to avoid unforeseen integration or conversion costs if existing systems are incompatible. Vendors can be quick to finalize sales, do the responsibility falls to you to do your due diligence. Avoid surprises down the line by working with the vendor to understand compatibility issues before they drive up project costs or delay implementation.
#2: Setting a Project Budget That Has No Contingencies
In an effort to make a compelling case for a major project like an EHR platform implementation, organization leaders may sometimes understate the full costs of the project. This can be an expedient way to get a project approved, but it may lead to obvious problems down the line. Regardless of the actual dollar amount invested, budget overruns are a red flag; luckily, you have some control over your own budget goals. Be sure you’re arriving at a number that isn’t setting you up to fail down the line.
Beyond unexpected contingencies, there are costs associated with a successful project that continue past the go-live date. Funds should be included for both platform optimization and its ongoing support, both of which are often essential to ensuring you’re getting the maximum value out of the new system. Most EHR systems experience some growing pains and it's essential to incorporate end-user feedback after they’ve spent significant time with the system. Not budgeting for this makes it difficult to leverage this feedback to improve the system, and some of the benefits of the EHR platform may fail to materialize.
You can also safely expect that certain parts of the EHR project will exceed initial budget estimates, especially if contract terms are not thoroughly outlined or understood. Smart budgeting is flexible enough to account for some percentage of these unexpected costs.
#3: Failing to Assess Your Current Team
Performing an honest assessment of staff competencies with technology as well as their perspectives on new technologies is one of the keys to scoping a project well. It’s good to start with both IT and informatics staff, but also look at end-users as well.
It’s important to gauge your IT team’s ability to help you reach project goals. If certain competencies are lacking, you’ll have to make adjustments to your plans; if team members have identified weaknesses with current technologies, it’s important to assess how these will impact the project. Consider whether or not your existing software tools are up-to-date, or whether you’ll need to do work to prepare for the new platform.
Most importantly, you should try to develop a clear picture of your end-user’s abilities. By assessing staff in clinical, pharmacy, and billing functions, you can gain insight into how prepared these key end-users are for the new EHR platform. If technological competency and enthusiasm is lacking, project planning must account for costs associated with outreach and increased training.
#4: Neglecting Key Clinical Stakeholders
It’s crucial that you spend time engaging with key stakeholders during the scoping process, especially those among the clinical community. The use of EHR systems by physicians and nurses is often pivotal to the success of the platform.
Working with key staff including the Chief Nursing Officer, Chief Medical Officer, and the Director of Pharmacy, in order to understand the general concerns of their departments is extremely important, and also allows information about the EHR to filter down to clinicians and pharmacy staff in the most effective way. Staff members may be more likely to listen to their own team leadership than unfamiliar IT project staff.
You should also work to understand the day-to-day concerns of clinicians in relation to the new system; giving them opportunities to provide feedback before, during, and after the project can go a long way toward discovering and addressing potential problems in advance. Making clinicians feel like they are part of the process also generates good will that can serve buffer against bugs and other problems. After all, clinician frustration is the most likely point of breakdown of EHR, so anything you can do to mitigate it can be valuable.
By avoiding these common scoping mistakes, organizations can ensure that projects start on the right path.
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