Communication Strategies for EHR Implementations

By Rosie Montemayor

We are constantly reminded of how important communication is to the success of a culture-shifting project such as the implementation of an electronic health record (EHR). Whether you are moving from paper or from another EHR, the journey from planning to adoption is a marathon. Communication throughout is far from “fluff” or “nice to do” – it’s mandatory for adoption. Assuming you’ve already bought into this concept, we’ll point out some communication strategies you can employ during this important endeavor.

Company-wide Communication Strategies
One rule of culture change is that the more people are exposed to something new, the more they get used to it. You want your EHR to become “familiar” to users long before it’s rolled out. Sound impossible? Not at all – here are some ideas:

• Perform the workflows on paper.  While designing workflows for the new EHR, take the opportunity to improve them. Further, you can use the new workflows to encourage adoption with users long before the new system is implemented.  Communicate the new workflows, and use a combination of paper forms and your current system to start employing the new workflows. This is a safe and very productive use of your time, as it will help users get familiar with the “new” way without needing to let go of the “familiar” way.
• Use existing communication vehicles to update staff on EHR progress.  Posters, signs and banners are great visual communicators. In addition, communicate through vehicles that are already established such as corporate newsletters, intranet, status reports, etc. The predictable frequency of these communications makes them more effective than one-off messaging. Also, ask project team members and senior staff to speak directly to users at standing meetings.
• Host demos. Put the demo schedule on the intranet, in the newsletter, etc.
• Leave the “IT speak” at the door.  When you are communicating to non-IT people, do not assume they know your language.  Spell out acronyms and refrain from industry jargon.
• WIFM. In each and every communication to each and every stakeholder group, answer the question, “What’s in it for me?” When you describe a feature, be sure to include the benefit. Make the user the focus, not the system. Get people excited!
• Let senior leaders carry the message. An EHR update in the newsletter written by the CEO will have more impact than an update by the IT department. It’s crucial to demonstrate senior leadership support and active participation in this project.
• Include the five “Ws.” In your communications, tell stakeholders what (is an EHR), where (rollouts will happen), why (are we doing this), when (will it affect me) and how (will it affect me). It’s the easiest format. 
• Build in feedback loops. Unvoiced, unanswered concerns grow. Adequately answered concerns shrink. Hold focus groups. Dedicate an email box to the project for anyone to ask questions at any time. Install comment boxes throughout the organization for people who want to be anonymous. This also means you have to respond in a timely manner – so be sure you have a staff person dedicated to this task. Also, incorporate users’ questions and answers in training materials and FAQs (frequently asked questions – another easy-to-read communication format).
• Don’t start at the first rollout. Start communicating months before the first change happens on the floor. Make the business case. Describe a day in the life of various roles. Create a vision so that people can start to get used to the future.
• Don’t stop at go-live. If you’ve heard of or have experienced “buyer’s remorse,” you’ll know that it is important to reinforce the benefits of the EHR after it has gone live. It’s also a time to provide tips and tricks, etc. Most importantly, it is a time to congratulate users for pitching in, pulling together, and making the organization better for employees and patients.

Project team responsibilities

• Establish regularly scheduled meetings with each clinical site weeks to months prior to implementation.  Communicate meeting expectations and timelines to accomplish tasks and make decisions related to the rollout. The project team should view these meetings as an opportunity to open lines of communication, identify site-specific issues and respond to concerns and questions.
• Identify and areas that will be best served by standardization communicate this to users and demonstrate how the standardized functions or processes will work.
•  Attend staff and physician meetings before, during and post go-live to answer any questions and concerns directly.  This communication should continue (monthly or quarterly) post go live until the clinical site feels comfortable and has had the opportunity to embrace and accept the change. 

Clinic site responsibilities

• Identify clinic leadership and staff members to serve on a committee that will participate in project-related meetings and help ensure clinic issues and concerns are addressed.
• Identify possible issues or roadblocks and discuss possible options with the project team.
• Recommend communication vehicles and methods to the project team, and act as champions and point people.
• Continue to introduce continuous improvement workflow processes by communicating with sites already live, i.e., tips and tricks updates, best practice workflows, etc.
• Take meeting minutes or review those written by a project team member after each meeting. Distribute the notes to key stakeholders.  This will minimize any misunderstandings and will provide opportunity to address any discrepancies.

These are just a few ways an organization and project team can help facilitate and maintain open lines of communication throughout a project.  In the end, good communication makes users feel like they were part of the project’s success. Not everyone will be accepting and willing to partake; however, by communicating expectations, goals, and outcomes, all users will know what to expect and hopefully embrace the change over time.

Rosie Montemayor is one of Hayes’ Allscripts Enterprise EHR subject matter experts with more than ten years of implementation and project management experience in the outpatient academic healthcare environment.