EHR Implementation


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


Stages of a Successful EHR Implementation

Step 1: Assemble Your Team of EHR Implementation Experts

You’ll need the right team of people within your agency to carry your EHR implementation forward. This team will become your internal EHR experts and will 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 EHR 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.

EHR Implementation Team Roles

  • Team Lead: The team lead is the main point of contact between your agency and Foothold Technology. They are ultimately responsible for bringing your implementation process to completion: this can involve delegating tasks, scheduling calls with us, and finding the right program leads to answer questions. They will communicate the full database management plan to your staff 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: We recommend including Quality Assurance staff to ensure that you are meeting documentation requirements when configuring your EHR.
  • Training Team: Members of your training team will be responsible for learning your EHR software in depth, so that they can start training other members of your staff. They will also establish a process for deciding who will attend future Foothold trainings 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 Foothold 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 referrals sources.
  • Lead for Each Program: For each program that you want to set up within your EHR, 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: Define the Data Your Agency Needs to Collect

Each agency partners with a dedicated Implementation Consultant with extensive experience in human services. Your Implementation Consultant will be your guide through your entire implementation process. Every week, you will review a new piece of your workflow and the corresponding EHR module. They will help configure the software to ensure that your EHR can capture and report on the data that your agency needs. After each meeting, your team will fill out a worksheet with your configuration preferences, and your Implementation Consultant will adjust the software accordingly.

Since your agency probably runs a variety of programs, your Implementation Consultant will ask which programs you would like to implement in your EHR. To simplify this process, they will help you group your programs according to similarities in service planning, funding, and staffing.

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.

Step 3: Match Your EHR to Your Workflow

Beyond making sure that your EHR collects the data that you need, your Implementation Consultant will match your software to your agency’s unique daily operations. 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 front-line clinicians to your executive directors. Here are a few questions that your Implementation Consultant will consider along with your team:

  • 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?

Step 4: Enter Your Data!

At this point, 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 to Enter Your Data?

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.

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.

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

Step 5: Training Your Team

Your Implementation Consultant will work with Foothold’s training team to create a custom training agenda for your agency, so you can maximize your learning on the modules that you will use the most. Foothold practices the Train-The-Trainer model, where we train key staff members at your agency who can then train and support other users. This model empowers your staff to easily onboard new hires on an ongoing basis. During the full staff training, it’s helpful to have a few members of your implementation team present in order to answer questions from staff members who were not part of the initial configuration process. After training, your Implementation Consultant will help you develop an ongoing internal training plan.

Step 6: Going Live With Your EHR

By the time you complete training, your implementation team will have configured your new EHR, learned how to use and manage it, and filled the database with the data you need to begin using 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:

Ensure Hardware 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.

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. We also suggest that system administrators test permission settings for all groups, to ensure that everyone has access to the correct portions of your software. This is important for both client confidentiality and clinicians’ ease of use.

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. Of course, Foothold’s team will also be ready to help you resolve any issues that come up.

Continue to Partner with Your Foothold Team.

You will continue to meet with your Implementation Consultant after your go live day, allowing you to request changes, refresh your training, and continue to get support as you adjust to your new EHR. Your Implementation Consultant will ensure a smooth transition to your Senior Customer Success Manager, who is the Foothold staff member that will stay with you for the lifetime of your contract with our company. Implementing an EHR can be a complex project. 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.

What Is An Average EHR Implementation Timeline?

The time it takes to fully implement an EHR depends largely on the complexity of your organization and your team’s project plan. With the right team members and processes in place, we’ve seen that most EHR implementations take around 4 to 6 months. However, some agencies choose to implement their EHR and then gradually transition all of their programs onto the software over time. This approach may be easier to manage from an organizational change perspective, but will make the process longer. 

What Are Some 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. 

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