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Deborah Leyva

I agree with your “phased” components of an EHR implementation, but as a former technology person, I suggest that EHR implementations have a slightly different roadmap.

As with all technology implementations, across all industries, requirements should drive the implementation. In a practice, for example, these requirements take the form of an “As-Is” picture that describes the existing people, processes, workflow, and technologies used.

The target, or the “To-Be” position is the goal. If there is desire (and I expect there will be) to receive federal stimulus financial incentives, then the goal must meet the. as of yet, unfinalized meaningful use criteria. (Expectations are that these criteria will be finalized in 1Q10.)

That said, the current matrix describes many of the “new” reporting requirements to assess meaningful use with electronic health records. Regardless of the criteria’s current status, health professionals should become familiar with them in order to assess how their existing processes may be impacted via compliance. A huge area with significant impact, and one that is already in effect, are the “improved” HITECH / HIPAA Privacy & Security Rules.

Finally, when the starting and ending points are known, the “roadmap” can be developed and it will include many of the phases identified in your article. That said, EHR implementations are not a step-by-step process, but rather, they are an iterative process. This means that providers and/or facilities must recognize problems along the way, prioritize, iterate, fix or postpone the solution, educate clinicians, and assess results throughout the implementation. Once the system is successfully operational, then of course, maintenance and support follows.

For more information on EHR implementations you may be interested in a presentation I gave at the World Healthcare Technology and Innovation Congress on this topic at

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