Lessons Learned from Pilot Site Implementation of an Ambulatory Electronic Health Record
Open accessAbstract
As ambulatory care practices face increasing pressure to implement electronic health records (EHRs), there is a growing need to determine the essential elements of a successful implementation strategy. HealthTexas Provider Network is in the process of implementing an EHR system comprising GE Centricity Physician Office-EMR 2005, Clinical Content Consultants (now part of GE), and Kryptiq Secure Messaging throughout all 88 practices in the Dallas-Fort Worth area and is hoping to extend the system to other practices affiliated with Baylor Health Care System as well. We describe the preimplementation clinical process redesign and quality improvement training that has been conducted networkwide in preparation for the introduction of the EHR, as well as the specific steps taken to prepare and train clinic staff for the integration of the EHR into daily workflows. The first pilot site, Family Medical Center at North Garland, implemented the system in May 2006. Based on both the positive aspects of this experience and the challenges we encountered, we identified 20 essential elements for successful implementation in the areas of site selection, implementation strategy, staff education and preparation, team project management, content, hardware and software, and workflow process. Broadly, we determined that 1) a pilot site's understanding of and willingness to work within the fluid nature of the implementation process during what is essentially a testing phase is a key ingredient in achieving success at the pilot site and in improving the process for later sites; 2) input from and representation of viewpoints of all types of EHR users during preimplementation decision making enables customization of the system and sufficient preplanning to ensure minimal workflow disruptions during and after implementation; and 3) a high level of technical and training support during the early days of implementation is invaluable.
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Real-time troubleshooting facilitates the effective use of the eHealth system.
“Real time troubleshooting (especially through internal resources) facilitates the effective use of the eHealth system and becomes essential to the system success in terms of actual usage [49,124].”
From Health Care Provider Adoption of eHealth: Systematic Literature Review (2013) · cites this paper as [124]
Real-time troubleshooting is essential to the eHealth system's success in terms of actual usage.
“Real time troubleshooting (especially through internal resources) facilitates the effective use of the eHealth system and becomes essential to the system success in terms of actual usage [49,124].”
From Health Care Provider Adoption of eHealth: Systematic Literature Review (2013) · cites this paper as [124]
Internal IT staff may respond more quickly to an urgent request than external support services from the IT vendor.
“Compared with external support services from the IT vendor, internal IT staff is more familiar with the work environment and related needs, and may respond more quickly to an urgent request [124].”
From Health Care Provider Adoption of eHealth: Systematic Literature Review (2013) · cites this paper as [124]
Internal IT staff is more familiar with the work environment and related needs than external support services from the IT vendor.
“Compared with external support services from the IT vendor, internal IT staff is more familiar with the work environment and related needs, and may respond more quickly to an urgent request [124].”
From Health Care Provider Adoption of eHealth: Systematic Literature Review (2013) · cites this paper as [124]
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X Manual de Patologías y Protocolos de Urgencias Sanitarias
COLECTIVA, A. (2023) · doi:10.59466/lc10723wk0004
- Authors
- Fullerton, C., Aponte, P., Hopkins, R., Bragg, D., & Ballard, D. J.
- Corresponding author
- Ballard, David J.
- ORCID
- Ballard, David J.
- Venue
- Baylor University Medical Center Proceedings
- Publisher
- Informa UK Limited
- Published
- 2006-10
- Volume
- 19
- Issue
- 4
- Pages
- 303-310
- ISSN
- 0899-8280 (ISSN-L)
- 1525-3252
- OpenAlex
- W1866025273
- Cited by
- 40
- References
- 12
- Citations by year
- 2025: 1 · 2023: 4 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 1 · 2017: 1 · 2016: 1 · 2015: 5 · 2014: 2 · 2013: 4
- FWCI
- 5.85
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Baylor University Medical Center Proceedings (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Cedars-Sinai Medical Center
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Social Sciences › Business, Management and Accounting › Management Information Systems › ERP Systems Implementation and Impact
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Keywords
- electronic health record implementation, outpatient care, pilot sites, implementation strategies, quality improvement education, employee training, workflow integration, site selection, user participation, technical support
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