EMR Update Decisions Benefit from Analysis, Strong Governance

If you own a smartphone, you know that your personal apps and even your operating system are subject to frequent upgrades. The same is increasingly true for electronic medical records systems.

Epic Systems now updates its software quarterly, which is a recent change to their release schedule. Cerner also pushes out frequent updates, grouping them into three categories:  Major, Minor and Incremental.

As important as these updates are, the frequency and complexity of these changes can also be overwhelming, especially in understaffed organizations. From a planning and resource perspective, some upgrades are akin to a new implementation, requiring significant configuration and testing along with training and support for end users.

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As a result, many health systems faced with upgrades look for the path of least resistance—making small requisite code changes (e.g. bug fixes or security patches) but deferring on larger rollouts of new features or functionality.

In the short-term, this approach can minimize expenses. But delaying upgrades can also mean missing out on important changes that may make the system easier to use, or improve revenue capture, or enhance safety and outcomes for patients. These are opportunity costs that require consideration and analysis—and not just within the IT group.

Let Governance Guide Upgrade Strategy

As an IT consultant and project manager, I’m a firm believer in governance. During the heyday of Meaningful Use, many hospitals developed new and rigorous governance policies to guide their EHR Implementations. I advise clients to rely on those same principles to make decisions about upgrades.

A wise governance plan engages mid-level management from all venues, departments and service lines that use the software. Often the staff is unaware of the features and updates in code releases. They must be educated, so that end-users and their leadership can be equal partners to the IT group in making decisions about what to activate.

Effective governance for this process would include a multidisciplinary team to meet at least quarterly.  This group should understand and assess current system capabilities that are unused as well as future code releases and the features / enhancements in those releases.

Once this team has the knowledge of what their system can do with the periodic code releases, then good decisions can be made, projects can be planned and budgets can be allocated.  Larger changes may require a cost-benefit analysis. This is where the additional expenditure can be compared, justifying investment in a coordinated project.

Requesting outside expertise can also be helpful for a fresh perspective and to assess need and scope. Consulting firms like ours (and others), provide optimization and upgrade expertise to ease resource burdens and guide large projects to a successful conclusion.

Jim Beezley is Director, Cerner Consulting for Healthcare IT Leaders. Jim has led multiple, large-scale client engagements, supporting health system leaders with strategic goal setting & road-mapping, migration from legacy systems, implementations, optimizations, and user adoption.

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