Confidence? Check!: How One Agency Beat the EHR Implementation Jitters

by Ivy Raff, Implementation Consultant, Foothold Technology
with Leah Magagnotti, Director of Clinical Operations, Northwest Alliance
April 11, 2017

Two truths: change is the only constant in life, and when that change is organizational, there are bound to be challenges. Behavioral health providers often walk a tightrope, faced with multiple organizational changes at a time.

Northwest Alliance is a HIV/AIDS service provider in the heart of rural Pennsylvania. When they began their EHR implementation, they placed their database-savvy IT Manager at the helm, and cleared his schedule so he could focus solely on the project. When the IT Manager was suddenly called to active duty, Leah Magagnotti, the Director of Clinical Operations, added Implementation Team Lead to her already-long list of roles.

Initially, Leah had her doubts about the implementation process and whether Northwest Alliance would be able to integrate this new EHR into their existing workflows. Now, several months later, Leah’s staff is trained and confident, their database is seeded with client records, and Northwest Alliance is on the brink of a resoundingly successful AWARDS implementation.

How did they do it? One important tool was the “Pulse Check” – a survey they developed in-house to help them assess readiness for going live. Read on for a conversation between Leah and Ivy Raff, the AWARDS Implementation Consultant who shepherded Northwest Alliance through the process.

IR: Let’s talk about your Pulse Check survey, which you administered to your staff after EHR training. I shared it with my team here, and we love it! It hones in on specific areas staff were trained on. What made you think to administer a survey like this?

LM: We knew we were approaching go-live day, and we knew we’d trained our staff on everything they needed to know. But did they RECEIVE everything they needed to know? We wanted to identify areas that needed more technical training, and whether staff all have the same needs or different needs. So the Pulse Check asks yes/no questions, and staff rated themselves on how well they can perform each job function in the software.

IR: I noticed you peppered the language on the Pulse Check with a mix of AWARDS terms and your own internal terms. In my experience working with almost 80 agencies, the challenges we face aren’t so much that the software doesn’t do what they need, but that we’re finding a “happy marriage” between the terms they use, and the terms in the software. What was that language transition like for you?

LM: Well, we first had to realize that we needed a crossover language. For example, for us, intake and admission were always interchangeable. Whereas in AWARDS, they’re distinct steps, which we always wanted to track. At first, we stumbled over those words, and we had to overcome that mental barrier about what intake means. But we learned the crossover, and we used both languages when we trained our staff. As time went on, we phased in more and more AWARDS language.

IR: So your staff ended up having an easier transition than you, the implementation team, did.

LM: Yes, I agree. On the implementation team, now that we know so much more about how to administer AWARDS, we continually say, “We probably should have listened to Ivy!” We thought we needed to custom build so many things – but we should have listened to you when you told us native reporting functionality could take care of it.

IR: Did the results of the Pulse Check confirm anything, or surprise you?

LM: The verbal feedback we got after training our staff was along the lines of, “I feel like I was run over by a truck. I’ll never be able to do this. You’re stressing me out.” But the Pulse Check scores were great! When you drilled down to specific task knowledge, a lot of them had perfect scores.

IR: Impressive. It speaks to folks’ general jitters around change, as opposed to an actual lack of knowing what to do.

LM: Yes! We previously had two software packages. Case Managers had separate software and weren’t allowed to access the medical software. In AWARDS, it’s a shared record. If Case Managers enter a medication in AWARDS, they note that it’s from patient input, rather than a medication our medical staff prescribed. So they’re nervous about that, nervous about the ramifications if they make a data entry mistake. But they know how to do it.

My role is to help people feel encouraged, supported, and confident when they start this new adventure. If I just asked people to rate their confidence level, they’d give it a 1. But the truth is, their capabilities are so much higher. They can do much more than they think they can.

IR: Can’t we all!

About Foothold Technology
Foothold Technology, an electronic record, EHR vendor and human services software provider, offers web-based software for human service providers that eases the burden of documentation, providing agencies with the freedom to focus on their Mission. More than 1,000 agencies nationwide count on Foothold’s AWARDS software to manage their services, including Mental Health, Alcohol & Substance Abuse, Intellectual & Developmental Disabilities, Homeless & Housing, Employment & Training, Seniors, Veterans, Youth & Family, and more. Having originated from three agencies in 2000, AWARDS is a complete electronic record and EHR software for human service providers that also supports administrative activities, including facilities maintenance, human resources, scheduling and alerts, audit reports, and automated billing. AWARDS offers full interoperability with any other federally certified system for participation in Health Information Exchanges (HIE) and RHIOs. It is also the only record-keeping system that is certified as both a Behavioral Health EHR software system and an HMIS software package (Homeless Management Information System). With roots and origins in human services, no software vendor is better prepared to support you than Foothold Technology. For more information, visit