EHR Implementation

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Any EHR implementation can seem like a daunting task. Bringing in a new agency-wide technology tool can be a complicated project that requires a fresh look at the way your agency works. How can your agency implement an EHR without taking time away from the people you support?

Through decades of experience, Foothold Technology has developed a robust plan to make EHR implementation as smooth as possible for the agencies we work with. Over the next few sections, we’ll share our proven implementation steps and help demystify the implementation process.

We’ll also highlight how a successful EHR implementation can help transform the way your agency works.

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What is a Typical EHR Implementation Timeline?

The time it takes to fully implement your system depends largely on the complexity of your organization and your team’s project plan. The National Center for Biotechnology Information (NCBI) estimates that hospital EHR implementations usually take around 6 to 8 months. But with the right team members and processes in place, we’ve seen that most EHR implementations for human services agencies take about 4 to 6 months.

Before You Start, Watch Out for These EHR Implementation Challenges

In working with our customers, we find that change resistance is one of the biggest challenges that agencies face during implementation. With any new tool and change in process, there can be anxiety about learning how to use the new EHR and transitioning to different workflows.

We’ve seen that our customers have found the most success in change management by following a few key principles:

  • Involve staff as early on in the process as possible.
  • Communicate how the change will positively impact staff’s work and their clients.
  • Partner with program managers to configure the EHR to their current workflows, or take this as a chance to make workflow improvements based on staff recommendations.
  • Be patient with training and understand that staff will naturally hit roadblocks along the way.

6 EHR Implementation Steps for a Successful Transition

Step 1: Assemble Your Implementation Team

You’ll need the right team of people within your agency to carry your implementation forward. This team will become your internal EHR experts. They’ll lead ongoing tasks, like creating new forms, assigning permissions for new staff members, or changing access to client records for staff entering new roles at your agency.

Based on our vast experience with supporting implementations across the country, we have a few recommendations on how to strategically share knowledge across your agency and create your own database management team.

One of the first ways you can streamline your entire implementation process is by giving your team members specific roles.

Our Recommended EHR Implementation Team Roles:

After the initial configuration, your team will check to make sure the software supports your typical data collection process. For each program that you implement, your team will walk through the entire lifecycle of admitting your clients, planning and documenting their services, completing assessments, and discharging clients. The goal of this exercise is to ensure the database is ready for your staff to train on and use in their daily work. This initial configuration is also a great time to take a look at your agency’s current workflows and make sure that they are still fully optimized for your staff and your clients.

  • Team Lead: The main point of contact between your agency and your EHR vendor. They are ultimately responsible for bringing your implementation process to completion. This includes delegating tasks, scheduling calls, and communicating with program staff. They will communicate the full database management plan to your agency so that everyone knows who to go to with questions or troubleshooting. Think of the team lead as the internal project manager of your implementation process.
  • Quality Assurance Team: Include your Quality Assurance staff to ensure that you are meeting documentation requirements when configuring your EHR.
  • Training Team: This team will learn the ins and outs of your EHR software, so that they can start training other members of your agency. They will establish a process for deciding who will attend future training and for creating internal training materials. They will plan out the onboarding process for any new hires.
  • Internal Help Desk: Your internal help desk team will learn the specifics of your EHR’s functionality, so they can help troubleshoot and answer questions.
  • Permissions and Staff Logins Lead: This individual will set up your staff logins and manage permissions.
  • Form Creation Lead: This team member will help build and configure the forms that your agency needs to collect data.
  • Report Creation Lead: This staff member will lead the creation of report templates most commonly used at your agency.
  • Provider/Referral Module Lead: This individual will work with your implementation consultant to set up a module that houses your referral sources.
  • Lead for Each Program: For each program that you want to set up within your software, we suggest choosing a representative that will ensure your EHR is set up appropriately for that program’s data collection and workflow needs.

Step 2: Decide Which Programs Will Go Into Your EHR

Since most agencies run a variety of programs, you should think about which programs you want to implement in your EHR, and in what order. To simplify this process, try to group your programs according to similarities in service planning, funding, and staffing. Since most agencies run a variety of programs, you should think about which programs you want to implement in your EHR, and in what order. To simplify this process, try to group your programs according to similarities in service planning, funding, and staffing.

Rolling out the software to a couple of programs at first can give you a chance to learn more about what processes work best for your agency, before you roll out the system to the whole organization. Since most agencies run a variety of programs, you should think about which programs you want to implement in your EHR, and in what order. To simplify this process, try to group your programs according to similarities in service planning, funding, and staffing.

Step 3: Match Your EHR to Your Workflow

At Foothold Technology, each of our client agencies partners with a dedicated Implementation Consultant with extensive experience in human services. Our Implementation Consultants are their guides through the entire EHR implementation process.

Beyond making sure the EHR software captures the information their programs need, our Implementation Consultants will match the software to each agency’s unique daily operations.

Here are a few questions that you should consider at this stage:

  • Are your intakes centralized for the entire agency, or does each program have its own intake process?
  • Do you have a vetting process for referrals?
  • Do you need your assessments to repeat on a particular schedule?
  • What kind of post-discharge follow-up do you do for your clients?
  • Are there restrictions on which agency staff members can see which client records?
  • What reports do you need for your funders and internal auditing?

Structuring modules and forms so that staff can work efficiently through their daily workflows is crucial to helping your agency operate more efficiently, from your frontline clinicians to your executive directors.

After the initial configuration, the agency’s implementation team should check to make sure the software supports their programs’ typical data collection processes. You can do this by walking through the entire lifecycle of admitting your clients, planning and documenting their services, completing assessments, and discharging clients. The goal of this exercise is to ensure the database is ready for your staff to train on and use in their daily work.

This initial configuration is also a great time to take a look at your agency’s current workflows and make sure that they are still fully optimized for your staff and your clients.

Step 4: Enter Your Data!

At this point in the EHR implementation process, your agency will be ready to enter real client data into your fully-configured EHR. Your agency will need to make key decisions in terms of entering your existing client data.

How Will You Enter Your Data?

Manual entry versus upload: While our software has the ability to batch-upload thousands of records at a time, this may not be the best solution depending on the current state of your data. If your agency is using paper documentation or if your data quality isn’t up to snuff, manually entering client records provides you a fresh slate that could save you time and resources in the future.

Who Will Enter the Data?

Implementation team and/or clinicians: Some smaller agencies keep the work within the implementation team or clear some time on their administrative staff’s schedules to complete this step. For other agencies, clinicians may enter their own records by setting aside a certain amount of time per week. Either way, we recommend setting clear objectives and timelines for your entire agency to keep this project on track.

Manual entry versus upload: While AWARDS EHR has the ability to batch-upload thousands of records at a time, this may not be the best solution depending on the current state of your data. If your agency is using paper documentation or if your data quality isn’t up to snuff, manually entering client records provides you a fresh slate that could save you time and resources in the future.

Which Data Should You Enter During Your EHR Implementation?

Demographic data only, or demographic data and service plans: It’s often best to bring both your demographic records and service plans into your new EHR before you go live. However, since service plans need to be manually entered, agencies with tight work schedules may choose to enter service plans on a rolling basis as their due dates come up.

Which Data Should You Enter During Implementation?

Demographic data only, or demographic data and service plans: It’s often best to bring both your demographic records and service plans into your new EHR before you go live. However, since service plans need to be manually entered, agencies with tight work schedules may choose to enter service plans on a rolling basis as their due dates come up.

"We started clean [with our data] . . . and kept an archive of our old data for compliance purposes. Starting clean assured we knew exactly what data was entered. If we had wanted to import, however, I feel certain Foothold would have walked us through the process to ensure a clean transition."
Foothold Client Agency
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Step 5: Training Your Team

Our team helps our customers create a custom training agenda for their agency, so they can maximize their learning on the modules that their staff will use the most.
Foothold practices the Train-The-Trainer model, where we train key staff members at the agency who can then train and support other users. We find that this model empowers agency staff to manage their own system, while still having the support of their EHR vendor when they need it. Having internal agency experts will also make it much easier to train new hires.
Foothold practices the Train-The-Trainer model, where we train key staff members at the agency who can then train and support other users. We find that this model empowers agency staff to manage their own system, while still having the support of their EHR vendor when they need it. Having internal agency experts will also make it much easier to train new hires.

Step 6: Go Live With Your EHR

During any transition, it’s important to have a smooth go-live day to help maintain staff morale through a time of change.

Here are a few tips to make your go-live day a huge success:

1. Ensure Your Technology Equipment is Ready to Go.

If you’ve purchased any new hardware for your EHR, such as tablets or touch-screen laptops, you should test the devices at the location where they’ll be used. An easy way to perform a full hardware test is to walk through a complete chart workflow on a test client.

If you’ve purchased any new hardware for your EHR, such as tablets or touch-screen laptops, you should test the devices at the location where they’ll be used. An easy way to perform a full hardware test is to walk through a complete chart workflow on a test client.

2. Double Check Your Logins and Permissions.

You should double check that the correct user logins and permissions are in place. One week before your official go live date, we recommend that you confirm all users have successfully logged in to the EHR at least once and have filled out their own security questions.
You should double check that the correct user logins and permissions are in place. One week before your official go live date, we recommend that you confirm all users have successfully logged in to the EHR at least once and have filled out their own security questions.

3. Have the Implementation Team on Deck.

Even the most prepared agencies may run into a few unanticipated snags on day one. We recommend that agencies clear their implementation team’s calendars on go live day in order to resolve any unexpected concerns from your staff.

EHR Implementation is an Ongoing Journey

Implementing an EHR is a big undertaking. You’ll need a strong implementation team, buy-in from senior leadership, a clear understanding of your processes, and support from your program staff. But with the right team and a world of experience from your software vendor, any agency can make a seamless transition to a new EHR.

Our team has decades of experience in helping agencies of all kinds transition to a new EHR.