Implementation Progress and Sustainability Planning

Implementation Progress and Sustainability Planning
The Children's Clinic is now ten months into our implementation of EPIC. Now that implementation is completed the organization is looking into phase two of EMR, which includes ergonomics, new written workflows, forms, policies and procedures, staff training, interfaces, QI, centralization and standardization as well as new ways of monitoring staff activity and clinic operations. As we move forward in EMR, TCC is realizing that "we need to return to the basics" and review the above list in the context of an EMR system. For example, we are finding that the flows developed during the implementation may no longer fit our needs, staff have already developed their own work arounds or minor verbal changes to the flow were never put on paper. TCC is going now looking into documentation and assessment of these flows in the context of clinic flow. Another example is HIPPA forms and data protection, security - all of these issues must be reexamined with the increased accessibility of an EMR system.

Sustainability Planning: In thinking about this issue, it is important to discuss continued staff training. During implementation we had increased IT, helpdesk and vendor support. Within the EMR, staff's roles now have to be expanded to include more IT skills. For example, in the past the organization would hire an MA knowing that their experience included strictly clinical functions. In our current environment, not only does the supervisor/mentor/super-user have to train this individual on the clinical skills needed to be an MA, they must also include EMR software training. The ability to select appropriate individuals who have the clinical skill set, ability to communicate and have computer skills is now a part of sustainability.

Our planning now not only includes connectivity and hardware, but also includes every day operation activities such as staff training, written documentation, monitoring, compliances etc.