Why You Should Plan Your EHR Post Go Live Support Before You Go Live

“Expect the best, plan for the worst, and prepare to be surprised.” ~ Denis Waitley

Why is it that technically “successful go lives” often don’t feel so successful to the users? All the boxes have been checked not only for system readiness, but change readiness, and yet, once the EHR is “live,” the user community does not respond with the anticipated level of satisfaction. Why, you ask yourself desperately, is it that a system with significantly enhanced capability is not greeted with open arms? Coming from my perspective as a self-proclaimed “slow adapter,” it’s new and hard! Users attend training that seemed to make sense THEN, but NOW they are simply lost.

Why are many users dissatisfied or even temporarily petrified? It really boils down to a few reasons:

• The software is complex
• It doesn’t work like before
• The information shared is not absorbed
• The “Command Center” comfort blanket is missed

There are many challenges that impact the perception of go live success and the ability to quickly respond to users once the Command Center is closed. Your organization may have experienced some of the following:

1. Budgets have been stretched, and spending has been contained
2. Resources are reduced as the implementation and go live team members are disseminated
3. More analysts and effort are required post go live than initially imagined
4. There is usually some attrition of the organization’s support analysts post go live
5. The EHR analysts are exhausted after go live and are taking well deserved vacations
6. The IT Help Desk is not well versed in the EHR to provide front line assistance
7. Requests for functionality are flooding in, but EHR analysts may be busy responding to incidents

When given the opportunity, organizations should plan post go live support in conjunction with the implementation planning process. By thinking proactively about your post go live support and stabilization period, you’ll be able to better serve the needs of your users.

In 2017 a Black Book survey found that insufficient specialized technical support for clinicians and other users of the EHR can lead to physician burnout, reduced user adoption, and subpar patient care. In addition, 85% of the survey’s 4,446 respondents indicated that inadequate support affects their ability to deliver quality patient care. The survey also reported that by enhancing support, 77% of nurses and 89% of physicians reported gained loyalty because of positive end-user experience during advanced tech support.

What can organizations do to ensure user expectations are met during the post go live stabilization period? Consider establishing a support structure with a focus on rapid resolution and user satisfaction, either internally or with a partner. An external option could be a short-term managed service agreement to augment existing staff during the stabilization period. The benefits can typically justify the cost. Some suggested approaches and benefits are provided below.

1. Implement an EHR Support Desk to answer the “how to” questions. This service can offer:

• Strong Epic generalists with knowledge across major modules
• An understanding of the caregiver environment
• Deflection of Epic ticket volume (~40%) from more expensive, higher tier resources
• Reduced wait time for a response or resolution for caregivers
• Free higher tiered resources to address more complex issues

2. Establish a dedicated Keep the Lights On (KTLO) support team via a managed service to quickly address users’ incidents and routine requests, which will be very heavy initially. A KTLO team provides:

• Focus on incident and task management
• Routine service requests
• Routine maintenance
• Approximately 30-50% improved efficiency for in scope KTLO activities
• 100% budget relief for direct and indirect costs associated with turnover for support staff
• Approximately 30-60% less costly than external project resources
• Positive impact on team morale and user satisfaction
• Predictable IT spend for support services

3. Set up a system to allow your internal team to focus on user adoption and quickly address optimization requests. This is important because:

• The existing team is familiar with design decisions, knows the players and environment, and can help guide the users to understand and accept the design decisions.
• User questions and requests will be very heavy initially because Epic just “doesn’t work like the previous EHR.”

Implementing an EHR is a major investment which should be protected. Ensure user adoption and satisfaction with a focus on rapid user assistance by planning for your post go live support to stabilize the investment.