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Rebecca Wiedmeyer, President and Independent Contractor of Vela Consulting Group, discusses with Eric Fishman, MD an EHR implementation. Wiedmeyer takes us through each of the necessary phases before going live with an EHR solution.


Category: EHR Press
Date: January 5, 2010
Views:6,344 views
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Rebecca Wiedmeyer, President and Independent Contractor of Vela Consulting Group, discusses with Eric Fishman, MD an EHR implementation. Wiedmeyer takes us through each of the necessary phases before going live with an EHR solution.

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Eric Fishman, MD: Hello. This is Dr. Eric Fishman for EHRtv and today, we have a special guest, Rebecca Wiedmeyer. Rebecca is an independent, electronic medical records consultant and throughout her career, she has worked with over 30 client sites implementing a variety of EMR's in both the inpatient and ambulatory worlds. She is a graduate of the University of Wisconsin and received her master’s degree from Duke University. Rebecca, thank you for joining us.

Rebecca Wiedmeyer: Thank you for having me. It’s my pleasure to be here.

Eric Fishman, MD: Thank you. I understand you have more experience in implementing EMR's than most people, having started actually quite a number of years ago. You, as I understand it, had worked for some of the larger EMR companies themselves doing their implementations and currently, are working as a consultant going from place to place around the country. As I’ve said, you’ve done over 30 large scale implementations, many ambulatory implementations and you started when it was still a novelty. Now obviously, hundreds of thousands of physicians have gone through the process but you were one of the early adopters, one of the teachers of the early adopters. So if we can, and we’re going to go through this in a systematic fashion what an implementation should look like, but let’s start with some of the highlights. What are two or three pearls, two or three important things, that you’d want to tell physicians who are just starting the process of looking for an EMR?

Rebecca Wiedmeyer: Absolutely. I think one of the most important elements to any implementation, regardless of vendor, of the EHR is provider adoption and participation through the implementation process. The end users feedback is absolutely critical for the success of your implementation, the success of the adoption of the EMR.

Eric Fishman, MD: When you say provider, I assume you’re speaking about more than just the physicians, but probably the physician’s assistants, nurse assistants, the nurses, the medical assistants, secretaries. Tell us how each of them should be involved in the process.

Rebecca Wiedmeyer: Absolutely. We’ll get into this a little bit later when we discuss designing your systems as part of the implementation process. Having the right stakeholders in the room during those design sessions, bringing the knowledge of what they do today in the paper world on a day-to-day basis; bringing that information to the table and having an effective project manager or physician champion taking that information and translating it into a correct setup for your organization.

Eric Fishman, MD: We’re here today to speak about implementation, but having spoken with you earlier, I understand that it’s your opinion -- and mine as well -- that a proper implementation starts in the readiness assessment stage. That you need to determine what it is that you want to accomplish and then, even in the selection stage, you need to know what workflows you’re going to be doing. So if you can step back and go to the pre-implementation stages and talk about what somebody should be doing, even before they’ve selected the vendor of choice, to determine and facilitate a proper implementation, that would be helpful.

Rebecca Wiedmeyer: Before a vendor is identified or selected, I think it’s important to recognize what you’re looking to achieve by implementing your EMR. In order to do that, you need to begin the discussions on the scope of functionality that you’re thinking is appropriate to bring into your organization. In other words, how much of your workflows that are 100% on paper today are you looking to transition to the EHR

Eric Fishman, MD: Perfect. Can you give us some examples of what you mean by scope? I assume you mean do you want to do e-prescribing, do you want to do billing but give us maybe a larger laundry list of what you have in mind.

Rebecca Wiedmeyer: I’ve worked with many clients that have advanced beneficiary notices on paper today. Some of those clients decide that that process will remain on paper even though the majority of their clinical processes are now within the EHR. That’s an example of a scope decision. Other clients have opted to integrate ABN’s into their EHR and that’s, again, an alternative scope decision.

Eric Fishman, MD: I would imagine that most state-of-the-art products at this point and time would be capable of accomplishing either of those methodologies.

Rebecca Wiedmeyer: Absolutely.

Eric Fishman, MD: So it’s a decision making process that the practice itself needs to undertake, if I understand correctly.

Rebecca Wiedmeyer: Absolutely, absolutely.

Eric Fishman, MD: So with that, if we could be a little bit more methodical with this overview and talk about the specific steps that you would encourage a practice, and let’s for the purpose of today, stay with smaller practices -- 1, 2, 3, 4, 5 maybe up to 10 physicians -- but let’s stay away from the inpatient world for now and discuss some of the systematic steps that need to be taken for a small practice to select, implement and most particularly, finish the process of implementing an EMR.

Rebecca Wiedmeyer: From the point that a vendor has been identified, it’s imperative to also indentify who your project manager is going to be, the person who will spearhead the implementation of your EHR. The designation of that individual is really going to depend on your specific organization budget, if you have an extremely savvy or motivated provider who wants to take this on as part of his or her day-to-day life as well --

Eric Fishman, MD: Excuse me, is that usually one of the physicians in a practice or can it vary and be anybody?

Rebecca Wiedmeyer: It may be. I have seen the project manager being someone assigned by the vendor; so a vendor employee. There’s independent contractors, like myself, who will come in and lead the project and then go bye-bye after the system is live. I’ve also seen organizations where there’s a very motivated or tech-savvy physician who really wants this to be his or her baby.

Eric Fishman, MD: That could be the physician champion?

Rebecca Wiedmeyer: Correct, correct. Physician champions exist -- and they should exist -- on any implementation. It’s the degree of responsibility of actually customizing and designing the EHR that may vary.

Eric Fishman, MD: So the physician champion does not have to be the project manager?

Rebecca Wiedmeyer: Correct.

Eric Fishman, MD: It can just be that person is the one encouraging the other practice participants to utilize the software.

Rebecca Wiedmeyer: Absolutely. The super user if you will.

Eric Fishman, MD: So after that step, where do we go?

Rebecca Wiedmeyer: As soon as you’ve identified who’s actually leading the project, it’s important to start analyzing your project timeline, doing milestone analysis and solidifying your scope. I gave an example earlier of scope but part of the process of project planning is identifying your rollout schedule for instance. Some provider practices like more of an incremental implementation where they want to start off with only limited physician documentation and eventually include ordering functionality and maybe scheduling down the road. So part of that planning process will be determining what’s in scope and attaching timelines and goals.

Eric Fishman, MD: You’ve mentioned timelines a couple of times and if you could, give us a range of expected times to do the implementation. So, again, we’ve chosen the vendor, we’re now going to actually start implementing and hopefully getting to go live in the near future. What’s a reasonable expectation as to how long that’s likely to take in a small office?

Rebecca Wiedmeyer: In a small office, it could be a matter of a couple of months. Depending upon how much customization and your rollout plan, it could be a year. It really depends on your organization and how fine tuned you want your system. What I’ve encouraged my clients to do is look at Go Live as the starting line rather than the finish line and start with a solid foundation but recognize that the system will need to be tweaked and optimized as you grow more and more familiar with it.

Eric Fishman, MD: That’s where the $44,000 comes in that a lot of physicians are looking for and the Go Live is, as you’ve said, very appropriately the starting line for that process.

Rebecca Wiedmeyer: Yes.

Eric Fishman, MD: Let’s get back to scope for just a moment if we could. We’ve discussed e-prescribing, there’s order entry and I mentioned billing. Can we address what the most common portions of an EMR are that people are interested in using in your experience?

Rebecca Wiedmeyer: Well, it can vary from organization to organization based on the provider personality mix, the end user personality mix and priorities within an organization. Some customers that I’ve worked with have had challenges in the billing arena, so they’ve elected to start with more of the billing aspects of the EHR. I usually encourage my clients to start with the clinical side and let billing practices remain in place; get providers really comfortable with the clinical workflows in the EHR so that you can then associate the billing and background to what providers are now comfortable with doing.

Eric Fishman, MD: Thank you. For those who are not that familiar even with the phrase “clinical portion” of an EMR, can you explain what that entails, what the universe of functionality would be?

Rebecca Wiedmeyer: When we discuss in the EHR world “clinical” versus practice management or billing, we’re really talking about end users who touch patients in any capacity. Whether its signing them into the office or whether it’s resulting labs on a patient, that would be more of the clinical side of the world and the obvious providers - nurses, nurse practitioners and so forth. Practice management side of the world would be more of registration. Billing is obviously your back office.

Eric Fishman, MD: So after the physicians and the practice in it’s entirely, in conjunction with the EMR vendor and or consultant, decide on the scope of what is going to be implemented, they will then have a timeline of which processes will be done in what sequence. What’s next after that?

Rebecca Wiedmeyer: Basically, in conjunction or concurrent to that, your organization should really plan for a kick-off. When I say kick-off, it is really a transition meeting between the sales staff from the vendor, your project leadership, your physicians and other stakeholders. Really, getting everyone in a room together and making sure that expectations are shared and common across the room, reviewing that project plan, those timelines, the scope and making sure everyone is clear. Far too often when the kick-off meeting has not been emphasized, I’ve walked into implementations where providers had a completely different set of expectations and are unhappy because they’ve been promised functionality that they’re not going to be getting for another two years. That was not conveyed to them, it was not communicated.

Eric Fishman, MD: Let’s go back to the kick-off. You’re in a room with a lot of people. It’s a small office. You’ve got three, four, five physicians, medical assistants, physician assistants, secretaries - and there’s disagreement. How do you, as a consultant, address issues of that nature?

Rebecca Wiedmeyer: It can vary from issue to issue. If it’s something that is essentially leading the discussion down a rabbit hole, you’ll find the old hat trick is to write a “parking lot” item on the chalk board and follow up at a later meeting when there’s less emotion.

Eric Fishman, MD: So you’ll just move the meeting along and address issues that may not be as critical?

Rebecca Wiedmeyer: Absolutely, because when you have so many stakeholders in one room, they’re not necessarily all necessary to resolve one particular issue.

Eric Fishman, MD: Certainly. So after the kick-off, if we finish that issue, what would be the next process?

Rebecca Wiedmeyer: You would want to work out a design schedule. When I say design, I mean meetings where you have the appropriate end user stakeholders in the room discussing their workflows and their present practice as well as the project manager or the physician champion consultant or vendor. The project manager would demo what the vanilla package of the EMR offers to address the current practice, the current workflows, and where there may be an opportunity to improve present practice, given the project managers knowledge of the what system can do, what its capable of, the configuration options.

Eric Fishman, MD: Let’s stroll down on workflow a little bit. It’s a word we hear a lot about and there may be some misunderstanding. Give us some examples of changes in workflow that could be expected for the better in the process of implementing an EMR.

Rebecca Wiedmeyer: In the ambulatory world, a great example is your telephone encounters. Today, maybe a unit secretary or a nurse takes a phone call from a patient, scribbles down a note and slaps it in the hand of the provider. In the electronic world, that telephone encounter can be captured. The information that the patient is providing to the person receiving the phone call is documented. The physician and others can access that information easily and it’s trackable for follow-up purposes.

Eric Fishman, MD: And a physician can see it outside of the office, frequently over an Internet connection, in a secure fashion?

Rebecca Wiedmeyer: Absolutely.

Eric Fishman, MD: Give us another couple of examples, if you would.

Rebecca Wiedmeyer: Prescription refill - same scenario as a telephone encounter. The patient wants to have their anti-depressant refilled but doesn’t want to come into the office. They call the nurse or they call the secretary. That gets scribbled down on a piece of paper, potentially lost. There’s a great degree of error there. Implementing an orders encounter within an EMR, the patient is served in a better manner in that they now have a trackable mechanism in place that has documented that their prescription was refilled as well as that is now part of their medical record. They’re trackable in case the patient comes in and the doctor might accidently prescribe a conflicting prescription. There’s the capacity within most EMR's to flag an alert.

Eric Fishman, MD: We’ll get to alerts in a few minutes. I believe you mentioned orders and we hear a lot about order sets. Maybe you can discuss how order sets can improve the care that physicians give and how that needs to be taken into consideration in the workflow analysis in the design stage.


Rebecca Wiedmeyer: Many customer sites that I’ve worked with have paper protocols or pathways. Or, if they don’t have it documented, they generally will have something in their heads. They know that they always order XYZ medications for patients with pneumonia. Or, there’s a state policy in place as far as how they handle patients with CHF. The important thing to realize with those sets is they can be re-created into the context of the EMR in the form of an order set. A provider, rather than having to write out all of those orders or check off all of those orders as they would in the paper world, now selects one order set. It has all of their defaults selected -- their favorite medications, their favorite lab tests, their favorite imaging studies -- and they just enter their password, sign their name and it’s as simple as that.

Eric Fishman, MD: At this point and time, I would believe that most EHR products would enable various physicians in the same practice to have separate order sets so if they have different preferences for an individual condition, they can select their own particular order set.

Rebecca Wiedmeyer: Absolutely, absolutely. Generally, what I’ve recommended is starting with very generic sets that can be utilized on day one of Go Live. From the foundational general sets, you would tweak and make it customized to Dr. Eric Fishman for example.

Eric Fishman, MD: If only I were continuing to practice but thank you. Is setting up the individual order sets what would be considered part of the design phase?

Rebecca Wiedmeyer: Absolutely.

Eric Fishman, MD: And tell me some other processes. You mentioned taking papers and making a determination in the earlier stages as to whether you want to keep it as a piece of paper or not but practices have letterheads, they have all of the HIPAA forms. Tell us about the design stage as it relates to all of those issues and any other design issues that may be there.

Rebecca Wiedmeyer: Correct. Prior to the design phase, you ideally have identified your scope -- what will remain on paper and what will be now translated into the EMR. So I have seen things like consent forms re-created in electronic format within the context of the EHR. That would be something where you would identify the paper form and re-create it and customize it to your organization within the EMR. I’ve also seen vital signs nursing flow sheets for templated documentation re-created in the context of the EMR.

Eric Fishman, MD: Let’s go back to the consent. As a surgeon, I’ve handled those pieces of paper many, many times in my life. Why would a practice not want to have an electronic consent? Is there a reason or, if you’re going to go electronic, is that just sort of the no-brainer that of course, you’ll want to have documents of that nature be electronic?

Rebecca Wiedmeyer: Well, you know, that’s a very interesting question because consents oftentimes come up as a very controversial piece. I think of the implementations I’ve participated in and I think a lot of it really is getting people to let go of the idea of paper as the end-all legality. It’s really driven by policy within an organization. Joint Commission recognizes the EMR as the true patient record and they have audited EHR’s as such. It’s usually the back office that maybe does not have as much of a stake in the clinical processes of the EHR that pushes back because it’s change; it’s a new aspect to their work flow.

Eric Fishman, MD: Thank you. You mentioned policy - and policy and practice don’t always go hand in hand. I wonder if you could elaborate on that a little bit.

Rebecca Wiedmeyer: Yes, absolutely. One thing to note right up front is implementations will inevitably bring to light the oftentimes wide gap between policies of organizations and practices; between what administration says to do and what is actually being done. So knowing that in advance is probably something to keep in mind. You won’t be as surprised when people start disagreeing during your design sessions.

Eric Fishman, MD: So now we’ve spoken about design. What would be the next step in a standard implementation?

Rebecca Wiedmeyer: After you’ve identified the changes that need to be made or the customizations that need to be made to the EHR as it’s provided by the vendor, the project manager would be responsible for going back and implementing those changes. So actually, customizing and building out the system to address the needs of the organization.

Eric Fishman, MD: That essentially needs to be somebody who’s familiar with the EHR systemotolgy that is necessary to do the customization. They’re sitting in front of a computer; it can be done in the office, it can be done in Hawaii, it can be done anywhere.

Rebecca Wiedmeyer: Yes.

Eric Fishman, MD: And it’s somebody who, not to misuse the word, implements the changes to the standard off-the-shelf product that have been requested by the practice in the design phase?

Rebecca Wiedmeyer: Absolutely.

Eric Fishman, MD: How much coding and special functionality capabilities is necessary? Is that something that a physician can do, something that one of their staff can do or, is that almost always done by either the vendor or a consultant who has a lot of experience with that product?

Rebecca Wiedmeyer: Many of the EMR's exist today with front end capacity to customize. So depending upon how savvy your organization is with the technology and how interested you are in doing it yourself -- making my screen as a provider different from the provider sitting next to me -- a lot of the EMR's have very easy to use tools that allow that kind of change. Some of the changes will invariably have to be done on the client side on the back end. Most EMR's, unfortunately, are not web-based yet, especially the major vendors who are more what they call “client server”. So the back side is where a lot of the changes need to be made.

Eric Fishman, MD: Thank you. Jumping past Go Live for a moment and then we’ll come back -- we’ve done this customization, the physician is using it and the screen looks however it looks. Is that something that’s frequently able to be changed after the fact for the physician?

Rebecca Wiedmeyer: That’s really a matter of policy within your organization. I think it’s important to set expectations about what we call, as consultants, change management. Upfront, as part of the kick-off process, would probably be a good opportunity to set expectations and say, “Okay, we’re willing to give you your own order set after Go Live but we’re not going to change the way telephone encounters look.”

Eric Fishman, MD: We’ve now talked about the customization. What would be the next step?

Rebecca Wiedmeyer: After you, as a project manager, have customized the system, you would want to take that customized system back to your stakeholders in what could be a one day validation session or, depending upon schedules and scope, it might be multiple days of validation.

Eric Fishman, MD: And this validation does not entail real-life patients using the system?

Rebecca Wiedmeyer: No.

Eric Fishman, MD: It’s just making sure that it does what it is that everybody thinks its doing.

Rebecca Wiedmeyer: Right. We generally try to offer a story or a scenario, a day in the life of a patient or a day in the life of a provider and walk through what you are doing today on paper, walk through what that looks like in the EHR space post the decisions made during the design phase.

Eric Fishman, MD: The validation process would be a day or two?

Rebecca Wiedmeyer: Correct.

Eric Fishman, MD: Is the office closed at that point and time, is it done on a week-end or is it just done behind the scenes while the office is still open and patients are coming through in the paper world?

Rebecca Wiedmeyer: That is going to need to be determined by the organization and resources, schedules and prioritization. Some provider practices make this a top priority and I’ve seen them close down the offices to attend these sort of sessions. Others, it’s a little bit more challenging and they want the project manager to run the sessions after hours or early in the morning. You kind of need to be flexible.

Eric Fishman, MD: So, we must be getting close to having actual usage of the EHR. What happens after the validation?

Rebecca Wiedmeyer: After the validation, very important pieces of the implementation -- testing of the product and training of the product. The project lead would be responsible for walking through and essentially trying to break the system -- oddball workflows, identifying any kind of bugs in advance of Go Live -- especially those surrounding medications where they could present a patient safety issue.

Eric Fishman, MD: During all of those preceding portions where we’ve got the kick-off, the design, the customization, the validation, I’m understanding now that there’s no actual physician and staff training of the software during those processes.

Rebecca Wiedmeyer: Correct. There’s continued demonstrations so generally, providers and stakeholders will have a familiarity with the system but might not necessarily know exactly how to use it.

Eric Fishman, MD: Give us a typical scenario for training if you would - how many days of training an individual person in the practice will need, how much time the trainers will be in the office.

Rebecca Wiedmeyer: Again, it’s going to vary based on scope. Let’s say because I’m so biased in terms of Big Bang, rollout the EMR. By Big Bang I mean, determining in advance you want it all and Go Live with it all and you go through the pain only once.

Eric Fishman, MD: Flick the switch and there you are?

Rebecca Wiedmeyer: Flick the switch and you’re there. In that scenario, I’ve generally seen about eight hours of provider training and I’ve seen it broken off into two separate afternoons. For smaller practices especially, it may be that you close the office for half a day and just get very hands on and get busy with it.

Eric Fishman, MD: Going live, do you recommend having a standard normal patient flow after that or, in most instances, do you recommend sort of curtailing it a little bit realizing that there will be some inefficiencies at the beginning?

Rebecca Wiedmeyer: I think expectation setting is important. Recognizing that, I’ve seen practices that have staffed an extra nurse for a day to help out with some things. I’ve seen bringing in one or two additional tech people to be there and assist with any questions providers might have for a week or so, or maybe less, depending upon your organization. Go Live support is very frequently offered in the consulting world as well but in general, I would recommend do what you do on a day-to-day basis within the context of the EMR.

Eric Fishman, MD: I thank you for this very clear explanation. Having done over 30 implementations, I bet you’ve seen some phenomenal successes and I’ll ask you to talk about those in just a few moments. Can you tell us about some of the failures and, without mentioning any product or facility names, tell us the types of things that have happened and if you can, why they happened where we ended up with an adverse event?

Rebecca Wiedmeyer: Well, I did work at a certain hospital where the providers working in the ICU just refused to use the system.

Eric Fishman, MD: Why was that? Do you think it was because they weren’t engaged at the beginning? Do you think it was an inferior system that everybody knew was not likely to be functional?

Rebecca Wiedmeyer: I think it was because they were not engaged in the beginning and I think it was because the level of executive sponsorship that is really imperative to the success of the adoption of the EMR, was not present.

Eric Fishman, MD: What do you think could have been done early on to have prevented a failure of that nature?

Rebecca Wiedmeyer: Had I been responsible for the inpatient aspect, the clinical documentation and orders aspect of that implementation, I would have held an ICU specific design session where it really would have given the providers an opportunity to feel special, feel engaged, clarify their workflows and develop a familiarity with the system.

Eric Fishman, MD: Thank you. Any other failures come to mind as something to be worth noting?

Rebecca Wiedmeyer: I think the biggest failures that I’ve come across stem from the same place -- not engaging providers; being very prescriptive from an IT perspective as far as what providers need rather than what they want.

Eric Fishman, MD: Fair enough. Now let’s talk about some of the successes and what types of benefits to physicians in particular and then of course their other stakeholders such as the insurance companies, the staff, the patients of course, get from a properly implemented EHR, but let’s stick with the physicians. What type of benefits in successful implementations have you seen?

Rebecca Wiedmeyer: The obvious is improved quality of care for the patients. Everything is now tracked and you’re able to provide much better care to the patient in terms of the system assisting you. For conflicting medications or medication allergy interactions, I read a statistic recently that medication errors and adverse effects of medications is the number five cause of death in this country and that needs to stop. The EHR is an extremely helpful tool in that regard. I think what providers may not be aware of is, as they grow more and more comfortable and familiar with the EHR, there’s an opportunity to really show its return on investment. You’re capturing a lot of data and you’re able to leverage that data in a number of ways to really show the financial benefits to your practice.

Eric Fishman, MD: Are physicians able to see patients either more comprehensively, code at a higher level, see patients and document in a shorter period of time? Are there any time improvements from a physician’s standpoint in seeing patients with the proper implementation? We’ve all heard hundreds of stories of disasters where the physicians are seeing fewer patients; they’re staying in the office later.

Rebecca Wiedmeyer: Yes.

Eric Fishman, MD: Tell us about some of the situations where physicians are actually able to see, in a professional fashion, a larger number of patients in the same amount of time.

Rebecca Wiedmeyer: Absolutely and I will include the caveat that at the point of Go Live, you should expect it will be slow because it’s unfamiliar. It’s like learning anything. There’s a curve; but once you master the EHR, you will find that your workflows improve in terms in time greatly. I gave you the example previously of a provider I spoke to recently who has cut down his dictation time from 10 minutes in total from dictating to using a combination of the EHR and Dragon to complete his documentation and has gone from 10 minutes to 4 minutes.

Eric Fishman, MD: Thank you. I think you know I’m involved in Dragon and I always love hearing things of that nature but it can be very helpful. Tell us other situations where there’s a particular additional technology whether it be Dragon or something else that facilitates the physician adoption of an EHR.

Rebecca Wiedmeyer: A tool that I’ve seen offered through many Pax vendors and independent archives of radiology and cardiology of that world, is a web viewer that integrates within the context of the EMR. General practice providers don’t have to go digging through films or they don’t have to go make a phone call and get an image from a Pax system from an ancillary hospital. Instead, all of this content is now readily available right in the context of where they’re working.

Eric Fishman, MD: Just to summarize, if you could briefly go through the steps from the beginning to the end of what the steps are for a proper implementation, I’d really appreciate that.

Rebecca Wiedmeyer: Absolutely. Step number one is identifying your project manager. It might be a consultant, a savvy physician or someone from the vendor themselves. The second step is project planning, scope identification. That step goes hand in hand with setting up your kick-off meeting. The kick-off meeting is meant to serve as the transitional meeting between your sales vendor and your project team. The third step is your system design sessions. That’s where you have the key stakeholders in the room and identify present practices and how they may translate into the EHR functionality. Following system design, we will want to build out and customize the EHR to meet the needs of your organization. After that has been accomplished, you want to get all of your stakeholders back in the room and validate all of the build and the decisions that you’ve made as the final signoff. Following system validation, you’ll want to set up testing and training for your EHR. Testing to make sure that there are no patient safety concerns or bugs in the software and training so that your end users feel well equipped come day one of Go Live. Finally, you’re at Go Live, the starting line.

Eric Fishman, MD: Rebecca, anything else that you’d like to add?

Rebecca Wiedmeyer: I don’t think so.

Eric Fishman, MD: Thank you very much.

Rebecca Wiedmeyer: Thank you.

Eric Fishman, MD: This is Dr. Eric Fishman for EHRtv and we’ve been speaking with Rebecca Wiedmeyer, an implementation expert. Until next time, thank you.


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