Electronic Health Record (EHR) Implementations are complex and challenging. Even after substantial preparation, due diligence and physician commitment, implementations do fail. If you are struggling with an EHR implementation, here are four action items to help you navigate the storm:
1. Documentation is king. It is imperative that the customer maintain organized documentation that identifies the problem, when the problem was reported to the vendor and the vendor response. To the extent that the underlying agreement provides a Project Plan, Acceptance Testing or Change Control, the customer should carefully manage the relationship in accordance with these terms of the agreement. The customer should not rely on the vendor’s trouble ticket system for documentation of defects and vendor response. Trouble ticket systems are a method of communication, but cannot be relied on to include information communicated in e-mail or meetings. The customer should organize communications with the vendor by defect so that e-mail correspondence, associated trouble tickets, meetings, and vendor responses related to each defect can be tracked for follow-up, escalation and, when resolved, closure.
2. Know when to call in the experts. Access to information regarding the cause of the failing or failed implementation will ultimately determine whether the customer has a right to a refund of implementation costs. Legal counsel should be consulted early, and without disclosing their engagement to the vendor, to facilitate both the collection of information required to show whether a breach of contract occurred, and customer compliance with its obligations related to a troubled implementation. Alerting the vendor to the engagement of counsel or experts may create additional obstacles when attempting to collect information or resolve the identified defects.
3. Critical review of both sides of Project Management. Project Management can significantly impact the success of implementation. When facing an implementation failure, vendors often point to a lack of support from customer project managers and customer sponsors. The customer, with the assistance of counsel, should carefully and confidentially critically review the success of the project to determine to what extent, if any, implementation challenges are a result of customer staff.
4. Provide vendor a limited opportunity to correct the defects. After collecting, documenting and organizing the information relative to when, how and why the EHR implementation failed, and generally before initiating litigation, the customer should provide the vendor with an opportunity to cure the defects. The opportunity to cure should be finite and provide the remedy or course of action in the event the vendor is not able to cure the defect(s).
If you are, or think you may be, facing a failed implementation of an EHR or other health IT system, the Health Information Technology Practice of Hall Render can help you navigate the technical and legal challenges. For more information regarding this topic, please contact Michael T. Batt at 317.977.1417 or mbatt@wp.hallrender.com
