EMR implementation: Getting it right the first time

With the need for increasing productivity and efficiency in healthcare and the growing role of digital care, the need for a strongly performing electronic medical record (EMR) is pivotal. However, it’s not often an easy journey to get it right the first time. The implementation of an EMR system typically underpins a major organizational transformation that touches nearly every function in a healthcare enterprise.

Electronic medical records support the entire healthcare delivery value chain, from patient registration and appointment scheduling to management and transitions of care to discharge and billing. Having an EMR is also crucial to be ready for the current and forthcoming digitalization of care delivery. Organizational activity in this area has been spurred on by the COVID-19 pandemic. A global survey of 200 healthcare CEOs¹ in 2021 found that almost 50 percent of healthcare leaders were fundamentally revising their approaches to electronic health records (EHRs).

Given the complexity and cost associated with EMR implementations, it may be tempting for a healthcare organization to rush an implementation with the intention of making iterative changes down the line. However, shortcuts may not be the best route to choose. Based on KPMG’s experience in supporting these projects worldwide, shortcutting an EMR project can negatively impact benefits realization and lead to broader organizational disruption. In our view, using a robust implementation strategy is key to getting things right the first time and essential in helping to facilitate success, minimize delays, and increase health care worker satisfaction, as well as help decrease the chances of system usability being compromised.²

Given the high stakes and costs involved in these transformational initiatives, KPMG recommends taking a structured approach to preparing for and monitoring risks throughout the EMR implementation. KPMG professionals use an extensive EMR risk and readiness framework to identify the top nine major domains of risk that healthcare organizations should consider in advance of and during their projects.

Further defining “what good looks like” in each domain provides a concrete reference point for healthcare organizations to compare themselves for an honest assessment of their readiness. When taken together, these nine domains form the basis of a comprehensive project plan to help guide and prepare your organization for a successful implementation.

The Integrated Health and Social Services University Network for West-Central Montreal (CIUSSS West-Central Montreal) engaged KPMG in Canada to use the EMR risk and readiness framework to conduct an enterprise-wide assessment at the outset of their EMR project to identify specific risk areas that would need more attention from their leadership and board. 

New EMR systems provide a valuable opportunity to reimagine the way care is delivered in healthcare organizations. In our experience, getting implementations right the first time is achievable with strong planning and management. This upfront effort can help prevent many headaches down the road and ensure that organizations gain maximum benefit from the process.

• An EMR implementation can underpin a generational level transformation, affecting many aspects across healthcare organizations. Healthcare organizations require a clear focus on what they are trying to achieve and the risks they need to mitigate during their EMR implementations. Putting in the effort to get it right the first time through careful planning and strong program management may be more work up front but can help accelerate time-to-value over the short and long run.
  
  
• When preparing for an implementation, organizations should apply a customer lens and think about the end-to-end patient journey to consider how best to improve their experience through the transformation. It is equally important to consider how information needs to flow between, as well as within, departments to support clinician and staff and partner organizations. Thoroughly mapping out integrations, applications, and infrastructure are important foundational activities that can allow the organization to get more value from the data over time.
  
  
• Minimizing risks during implementation is not only important to get to a smooth go-live, but it is also crucial to helping staff adjust to the new EMR and workflows to help maximize adoption. Effective change and risk management are at the heart of successful EMR-enabled transformations, where leadership teams and workforces feel engaged, empowered and confident in their abilities to provide the best care possible for their patients.