Rinne ST, Brunner J, Mohr DC, Bearak AC, Anderson E. Practices Supporting Electronic Health Record Transitions: Lessons from Four US Healthcare Systems.
J Gen Intern Med 2023;
38:1015-1022. [PMID:
37798573 PMCID:
PMC10593676 DOI:
10.1007/s11606-023-08279-0]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 06/13/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND
Electronic health record (EHR) transitions are common and complex organizational changes, yet limited published literature is available to guide health systems that are changing from one EHR to another. Clinicians and staff end users at sites that have undergone EHR transitions may have critical insights that could inform future transitions.
OBJECTIVE
To assess end user perspectives on organizational practices that support successful EHR transitions.
DESIGN
Multi-site qualitative study of end users at healthcare systems that transitioned to a new EHR (either Epic or Cerner) within the prior 3 years.
PARTICIPANTS
Forty-two participants, including providers, clinical leaders, and informaticists at four geographically and organizationally diverse US healthcare systems.
APPROACH
We conducted semi-structured telephone interviews, which were audio-recorded and transcribed. We used content analysis to identify key practices that influenced EHR transition success.
KEY RESULTS
Participants described specific organizational practices that they found most helpful in supporting EHR transitions, and these practices transcended individual sites and EHR systems. We categorized practices based on how they were described relative to the stage of implementation. During pre-go-live, recommended practices included communicate rationale and anticipated outcomes of the EHR change; understand baseline workflows; and plan for appropriate customization. During go-live, recommended practices included personalize training and support; invest in robust internal support; reduce workload expectations; and proactively address challenges. The recommended post-go-live practice was to continue to invest in the change.
CONCLUSIONS
Our findings may act as a roadmap for future EHR transitions by identifying specific and actionable organizational practices across stages of implementation. These recommendations highlight the role of health system leaders in preparing for the organizational change, working with and supporting end users, and addressing challenges that arise.
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