Implementing an ambulatory electronic health record (EHR) demands that you build the best team to ensure the project’s success. The skill set of this “dream team” should include strong clinical and IT project management, as well as the ability and finesse to train the seasoned professional, yet novice user. There are several schools of thought on the background that best lends itself to a successful EHR implementation. Some administrators feel that the team must consist primarily of registered nurses. Others feel that the team should include members with a strong IT background.

Why not both?

In my 20 plus years implementing medical software applications — many of which were spent implementing EHRs — I have found that a successful implementation begins with a team whose members have a broad knowledge base in three key areas:

• Clinical environments
• IT project management  principles
• Education and training tools

In addition to understanding these elements, it is very important for all team members to be gifted communicators — they will need to build rapport with clinical support staff as well as physicians.

Know the Practice Inside and Out
During the initial phase of an EHR rollout, it is a given to consider the basic needs of end users. However, the real driver of success is a clear understanding of the people and the culture within the physician practice. Teams should be able to answer the following questions from the start:

• Is the practice a specialty practice (i.e. cardiology, endocrinology, dermatology)?
• What are the current workflows for the practice (i.e. check-in, check-out, patient rooming)?
• Is the practice currently doing any on-site testing (i.e. lab, radiology)?
• Does the practice have any mid-level providers?

This is just a sample of the basic information that must be collected. And while there are obvious benefits to having an implementation team with clinical knowledge, this is not to say that these teams must be completely made up of RNs and LPNs. Often times, simply working in a physician practice, particularly as an administrator (don’t underestimate those administrators!), is enough to have the necessary clinical knowledge to be an asset to the EHR planning process.

However, demonstrating a solid clinical background is not the only required skill …

Cover your Bases
A team whose members have a clinical background and an understanding of basic IT project planning would certainly be successful in delivering a highly functional EHR. However, if you can’t have it all, at least make sure that these three IT project management skills are covered:

• Project planning in an IT environment (including design and management)
• Tracking IT project milestones
• Managing change control within a domain

Knowledge is Power
Training is often treated like the forgotten relative of an implementation. But it is critical nonetheless. In my opinion, one of the most reliable methods is the “just-in-time” strategy. It provides end users with  training as close to the scheduled go-live date as possible and ensures retention of the information. A good training strategy is comprised of four elements: 

• Classroom time
• eLearning programs
• Webinars
• One-on-one training

Create Meaningful Connections
Remember to build rapport with clinical support staff and physicians. Easy communication proves to be invaluable during the design and build phases of the rollout, as well as during the training and go live.
Members who are able to effectively communicate with all employees and understand the culture in which they work will ultimately be able to deliver a better EHR implementation, one with end users’ needs in mind and an environment that supports the application and its users.