How to Implement EHRs

Step 2: Plan Your Approach

  1. Assess Your Practice Readiness
  2. Plan Your Approach
  3. Select or Upgrade to a Certified EHR
  4. Conduct Training & Implement an EHR System
  5. Achieve Meaningful Use
  6. Continue Quality Improvement
View tools for Step 2

Clarify and Prioritize

Building an EHR implementation plan becomes critical for identifying the right tasks to perform, the order of those tasks, and clear communication of tasks to the entire team involved with the change process. One effective first step in the planning process is for the team to segment tasks into three categories:

  • What new work tasks/process are we going to start doing?
  • What work tasks/process are we going to stop doing?
  • What work tasks/process are we going to sustain?

The start/stop/sustain exercise helps clarify what the new work environment will be like after the change and help the team prioritize tasks in the overall EHR implementation plan.

Steps in the Planning Phase

Here are some tactical steps that typically occur during the EHR implementation planning phase. You may collaborate and use tools provided by your Regional Extension Center (REC), IT vendor, and/or EHR: vendor (if you already have an existing EHR product) to complete these activities.

  1. Analyze and map out the practice’s current workflow and processes of how the practice currently gets work done (the current state).
  2. Map out how EHRs will enable desired workflows and processes, creating new workflow patterns to improve inefficiency or duplicative processes (the future state).
  3. Create a contingency plan – or back-up plan – to combat issues that may arise throughout the implementation process.
  4. Create a project plan for transitioning from paper to EHRs, and appoint someone to manage the project plan.
  5. Establish a chart abstraction plan, a means to convert or transform, information from paper charts to electronic charts. Identify specific data elements that will need to be entered into the new EHR and if there are items that will be scanned.
  6. Understand what data elements may be migrated from your old system to your new one, such as patient demographics or provider schedule information. Sometimes, being selective with which data or how much data you want to migrate can influence the ease of transition.
  7. Identify concerns and obstacles regarding privacy and security and create a plan to address them. It is essential to emphasize the importance of privacy and security when transitioning to EHRs. Get started using this Health Information Privacy and Security: 10 Step Plan.

National Learning Consortium Resources

The following resources are examples of tools that are used in the field today, and that are recommended by “boots-on-the-ground” professionals for use by others who have made the commitment to implement or upgrade to certified EHR systems.

Learn more about the National Learning Consortium >

The material in these guides and tools was developed from the experiences of Regional Extension Center staff in the performance of technical support and EHR implementation assistance to primary care providers. The information contained in this guide is not intended to serve as legal advice nor should it substitute for legal counsel. The guide is not exhaustive, and readers are encouraged to seek additional detailed technical guidance to supplement the information contained herein.

Reference in this web site to any specific resources, tools, products, process, service, manufacturer, or company does not constitute its endorsement or recommendation by the U.S. Government or the U.S. Department of Health and Human Services.

Namesort icon Description Details
Goals and Objectives for EHR Implementation

Guidelines intended to help define goals and objectives for EHR implementation and quality improvement.

* Persons using assistive technology may not be able to fully access information in this file. For assistance, contact ONC at onc.request@hhs.gov.

Download

[DOCX - 1.02 MB]

Information Security Policy Template

Information security policy template that can be customized to meet the needs of a practice. This tool is intended to be a starting point for organizations to define the technical controls and security configurations that users and Information Technology (IT) administrators are required to implement in order to ensure the integrity and availability of the practice’s data environment.

Download

[DOCX - 1.29 MB]

Security Risk Assessment Tool Security risk assessment tool intended to be a starting point for organizations to identify cyber security risks.

Download

[XLSM - 272.15 KB]

Workflow Process Mapping for EHR Implementation

Guidelines to help assess practice workflow through “AS IS” (how workflows currently exist) and “TO BE” (how workflows can be optimized through practice transformation) process mapping.

* Persons using assistive technology may not be able to fully access information in this file. For assistance, contact ONC at onc.request@hhs.gov.

Download

[DOCX - 1.03 MB]

Workflow Redesign Templates

This tool provides workflow redesign templates for practices to leverage while planning for EHR implementations.

Download

[PPT - 1.97 MB]

Process

  • Prioritize goals and objectives
  • Get input from clinical and support staff
  • Analyze workflow
  • Redesign workflow
  • Define project requirements to meet workflow and usability criteria
  • Establish a chart abstraction plan
  • Identify data migration requirements (if needed)

Outcomes

  • EHR implementation plan, schedule, and tasks
  • Current state and future state workflows
  • Chart abstraction plans
  • Privacy and security plan