Any EHR effort requires a plan to support the EHR technology. Some practices have created an information technology (IT) position or even a department. Unfortunately, many practices overspend on IT support that is more than they need technically, but less than they need operationally.
The key issue is deciding the level of technical assistance you will need for the long term and who will provide it. In too many cases, practices base their IT support strategy on the demanding and complex changes to hardware and software infrastructure for the move to an EHR. After the EHR is up and running, many practices find that they over bought their IT Support structure but failed to invest enough in supporting the use of the EHR. The solution requires a balanced look at your needs through implementation and your long term requirements.
Practices should consider a multi-layer support strategy that empowers users to keep the system running but provides escalation options for more serious issues:
Self Sufficient Users – In order to make the best use of your IT support investments, you need users that are self sufficient on a day to day basis. Typically, this involves training your users to deal with common problems that they may encounter: verifying connection to the network, initializing their workstation or browser, dealing with printers, and EHR application issues. You should consider establishing a list of basic skills that every user needs and provide initial and refresher training on the basic skills. With the best of intentions, organizations that do not invest in training users on basic skills will pay the price in continuing IT support costs and interruptions to operations that become more disruptive that necessary. For example, re-establishing wireless connectivity should be a basic skill for tablet users.
Super Users – In some cases, practices create an IT department that is responsible for completely supporting users. This may evolve into having IT support people in every department and on every site. Indeed, in some organizations, all problems are referred to an IT department for resolution. Such a strategy can be costly and not provide the coverage you need. Consider identifying a super user for each site or department depending on the size of the organization. Super users should be well trained on the EHR as well as understand hardware setup and recovery strategies. A front line super user will be more easily available and be able to prioritize the problem in less time and at less cost. As important, the super users know when to escalate a problem and will be a valuable source of continuing feedback on system performance and issues.
Dedicated IT Support Staff – For smaller practices, an IT department is not feasible but a dedicated IT Support Person may be warranted. For larger practices, an IT Department is a necessity. The real challenge is structuring the responsibilities of the department to meet your expectations on a cost effective basis. The scope of work for any internal IT support is to support the super users and maintain the technology base. As important, the internal IT staff will be a primary contact for your vendors. Any interactions with EHR vendors on technology issues will require someone on your side to analyze the vendor response and your practice strategy. Note that small practices may be able to meet their IT support needs by getting additional training for an existing staff person, or hiring an appropriate IT support person. Hiring recent IT graduates has been a successful strategy for a number of smaller organizations.
External IT Vendors – The IT support plan should include support from an external resource for the out of the ordinary issues and challenges. Even if you internal staff knows how to perform infrequent tasks such as installing servers or balancing workloads, you may want to avail your organization of someone who is performing these tasks on a weekly basis rather than internal staff that may only have an infrequent opportunity to install a new server. For example, reorganizing your storage units or addressing a hardware failure may warrant getting an external expert involved even if your internal resource has the knowledge, but not the experience, to handle the work on their own.
The key goal is to identify appropriate tasks for each level of support and the escalation plan for issues that require additional help. For example, larger practices may need an IT resource that can manage a set of servers and Storage Area Network as well as a communications infrastructure. However, such a person may prove expensive and temporary for the smaller organization. Even if your internal person may have higher level skills, you may be better off using an external resource for infrequent activities such as server configuration or changes to backup schedules and use your internal person to monitor and supervise the outside party.
Designing and implementing an appropriate support strategy protects your investment in IT as well as continuity of EHR availability for your organization. Using a strategy to capitalize on all users and creating a multi-layer support structure will help you provide more responsive and cost effective support for your mission critical EHR.
© Sterling Solutions, 2011