The following is a guest article by GP Hyare, Managing Director at ReMedi Health Solutions
One year ago, the average EHR go-live involved hundreds of support personnel flying to a hospital and working on-site for four to six weeks. Due to the COVID-19 pandemic and the inability for so many individuals to fly-in and stay in close quarters to hospital staff, EHR go-lives had to evolve. As the healthcare industry continues to adopt virtual solutions, the future of EHR go-lives will never be the same.
The standard EHR go-live had some obvious inefficiencies. They were costly, and it was often difficult to measure the performance of traditional at-the-elbow (ATE) support as they provided assistance to clinicians.
Hospitals planning go-lives today and in the future have to make more intelligent decisions with respect to the constraints caused by the pandemic, both operationally and financially.
In April, in the wake of the first major country-wide lockdown, many health systems put EHR transitions and initiatives on hold. One of our clients, a community hospital in the Northeast, delayed its much anticipated EHR transition to June of 2020. As the country peaked in cases, it seemed as if the go-live would have to be pushed to the summer of 2021.
The Virtual Command Center Model
The leadership team at ReMedi Health Solutions, comprised of experienced Physician Executives, Clinical Informaticists, Nurses, and EHR experts asked the question, how can we help our client with the EHR transition virtually? Most modern American companies had shifted to remote environments, and reports from Google, Twitter, and Microsoft suggested that the operations were sustainable and evidently successful.
Accordingly, our team at ReMedi, led by our CEO, Sonny Hyare, MD, carefully dissected the industry standards of the modern EHR go-live, and developed a remote hybrid model focused on efficiency and scalability.
What ensued was the development of an innovative, modernized Virtual Command Center that supported our client through its EHR transition. Along the way, we identified major efficiencies in data & analytics, cost, and project oversight that hold the potential to positively impact the way in which EHR go-lives are implemented in the future.
The Virtual Go-Live Opportunity
As the ReMedi team engineered its virtual go-live solution, we focused on three main objectives:
- Evaluating & refining support resources
- Reducing project expenditures for our client
- Improving the at-the-elbow support experience
We began by evaluating and refining support resources. Typically, IT consultants provide a single ATE resource for every three providers and one resource for every five nurses and front desk staff. We reviewed this ratio and focused on finding a method that would help us increase the ratio so that a single support resource could support up to ten clinicians, thus yielding more output from each resource.
Given the constraints of the pandemic, our solution needed to be more cost-effective than a traditional go-live. As a result, we knew that there would need to be efficiencies identified from a cost standpoint for our client.
Finally, as former clinicians and go-live support ourselves, we knew that oftentimes finding ATE support right when you need it can be difficult. Moreover, what generally occurred was a ticket being created and waiting days for a resolution. We uncovered a method to improve the experience for end-users and create a model that was better than traditional ATE support.
Critical components of At-The-Elbow support
The team at ReMedi studied ATE support in its traditional sense and determined the following components constitute effective support:
- Speed & responsiveness
- Empathy and knowledge
- Issue escalation and resolution
First, we understood that as clinicians are providing patient care, it’s imperative that support is delivered fast, and support personnel are highly proactive and responsive to their needs. In short, there is a need for “on-demand” support.
The next component of ATE support is centered on the end-user relationship. Can trust be built between support resources and clinicians? Does the support have expertise in the subject matter and are they able to coach end-users to build good habits within the EHR system. The support ought to be empathetic towards end-users and knowledgeable about the new EHR system.
Finally, and most importantly, during a go-live issues must be resolved quickly. The identification and escalation of issues must be seamless, and the quicker the resolution, the better.
Focusing on these critical support items, our team derived a seamless virtual solution that met all of these needs.
Help desk model Versus True At-the-elbow Support
ReMedi identified three major solutions within its virtual go-live model that solved many of the core needs of end-users as well as hospital leadership:
- Virtual Command Center (a single offsite location for support personnel)
- On-demand support using tablets located at the hospital and inside clinics
- Seamless, continuous remote desktop access which allowed support personnel to quickly diagnose issues
The main problem we found based on our experience working and leading EHR go-lives was rooted in the inefficiency and poor end user-experience of the help desk model. The process for clinicians to call into a main help desk line, escalate an issue, and then get help was an increasingly frustrating process. The virtual model that ReMedi created ensured that true instant at-the-elbow support was provided in lieu of a help desk model, which resulted in several positive outcomes regarding the aforementioned needs of end-users.
Here’s one comment we received from one of the physician end-users:
Over the years I’ve worked with a lot of tech support people and this team/system is the best! No need to submit a request ticket and wait three days. I think I speak for my entire staff in complementing ReMedi’s Tech Support – they are friendly, knowledgeable and always available to help.
The core function of the ReMedi virtual solution was the Virtual Command Center. ReMedi invested in a very spacious facility and modernized the space to meet CDC work protocols and ensured a safe work environment. The ReMedi Virtual Command Center housed virtual support personnel which yielded an effective chain of command for issue escalation and resolution.
How do we satisfy the needs of the end-users?
ReMedi strategically placed tablets in each room of the clinics, which made it simple for end-users to instantly connect with virtual support in a single button click. This setup also enabled face-to-face communications which harbored relationships and allowed virtual support to literally see the emotions on the clinicians’ faces as they embraced the new EHR system. Clinicians were encouraged to call Remedi support first thing in the morning, and remain connected throughout the day during the first week of go-live to simulate the in-person at-the-elbow support experience.
Finally, ReMedi’s seamless remote desktop technology made it easy for clinicians to give viewing access to the support team. Face-to-face, computer-to-computer monitoring helped support personnel view the system exactly how the clinicians saw it, and quickly diagnose the problem.
Birds-Eye View Designed for Healthcare Leadership
Within the command center, a custom internal ticket management system was developed by Physician Executives and utilized to identify system-wide issues. Internal communication tools seamlessly disseminated vital information from the command center ticket resolution team back to support, and ultimately to end-users. Each interaction created a data point, including call volume, issues submitted, issue types, all organized by location, which gave hospital leadership a birds-eye view of the implementation in real-time. The data generated at the command center gave hospital leadership the ability to see what was happening inside of each clinic. Hospital executives were able to focus on getting additional help to clinics in need.
What’s the significance of the Virtual Go-Live that a CIO would want to know?
ReMedi’s virtual EHR implementation model created significant data points and value additions that are highly relevant to the modern CIO:
- Cost-reduction of up to 30%
- Seamless expert triage
- 1:10 ratio of support between virtual personnel and end-users
- Relevant, useful, and secure real-time data
ReMedi’s Virtual Command Center reduced the hospital’s IT support expenditures up to nearly 30%. Eliminating the high number of local ATEs, hotels, airfare, and per diem, support was delivered virtually and achieved clear financial efficiencies.
Virtual support personnel within the command center were able to triage issues in real-time. Given a centralized location with instant communication, problems related to the EHR were quickly addressed and solved.
ReMedi’s experienced leadership team achieved a major efficiency with its virtual model; such that a single skilled resource located at the command center could support up to ten clinicians with ease. The command center’s automation ensured that each incoming inquiry was promptly addressed within five seconds. This resulted in building trust with clinicians and more build issues getting resolved quickly.
ReMedi’s Virtual Command Center was designed to be HIPAA compliant, and a focus on data and security gave the team the ability to slice and dice information into usable and relevant data points for hospital leadership on a consistent basis.
A more detailed view inside the ReMedi Virtual Command Center can be found within our detailed White Paper: The Virtual Command Center, where we dig into specific details along with anecdotes, case study details, and more data.
To read the in-depth white paper, click here.
Let’s get through this together
The team at ReMedi Health Solutions is thankful for all of the frontline healthcare workers that continue to support our communities throughout the pandemic. We’re proud to support hospitals with their core IT and EHR objectives, and our model will allow hospitals to push forward with their operations in a safe and efficient manner.
The Virtual Command Center is innovation fueled by crisis. The result, a more efficient method for hospitals to provide IT support to clinicians that creates a better experience for all parties.
We encourage all health systems preparing a go-live to have a conversation with our team of Physician Executives about how ReMedi’s approach to the Virtual Command Center can benefit go-live results tremendously. Our team can be reached at email@example.com.
About GP Hyare
GP is a passionate healthcare executive and leader of EHR operations and strategy, mainly EHR implementations and management. As Managing Director at ReMedi Health Solutions, GP helps healthcare leaders identify strategies that improve clinical workflows and EHR adoption for hospitals and physician groups. Throughout his career, GP has driven digital transformation for over 25 hospitals from legacy EHR systems to modern ones like Epic and Cerner. GP and his team at ReMedi manage end-to-end execution of positive EHR outcomes including data abstraction & migration, peer-to-peer training, Go-Live, and optimization. He can be reached at firstname.lastname@example.org or via LinkedIn.