Implementation Planning

Planning the implementation involves practice leaders, providers and vendors. Being ready for Day 1 requires a careful plan. The implementation of an elctronic health record (EHR) system can transform the practice, changing almost every process. All these changes must be managed consistently.

Readiness Assessment

Several tools are available to determine where a practice is ready for an EHR and where it needs assistance. Assessments include computer skills, commitments and general understanding of the project and why it is needed. Having a clear purpose will make the change easier for the entire staff and the patients.

Workflow Analysis and Redesign

The EHR will require both drastic and subtle changes to the daily processes of the practice. Each staff will need to learn the new way of doing things. Sometimes this is easily taught, but sometimes additional tools are needed for people to understand the changes. This might include documentation of both current and future workflows, or detailed procures with screen shots of the new software. Analyzing the gaps between the current way of working and the new world of EHR should be completed to assist in understanding the change.

EHR Training

Most vendors will provide training on the basic functionality of the system, and there may be a help desk for questions later. Learning the new EHR may be different for each user, depending on the role and experience of each person. Most vendors provide standard training modules by role, such as Medical Assistant, Provider, Biller, etc.). Create ways for people to get extra time on the system before Go Live.

Our implementation team have become experts in many commonly used EHRs and can help locate additional training help for practices who need more support than provided by their EHR vendor.


Decide if the whole practice will start together or which providers will start on which day.  Some practices choose to start with the practice management system and add charting later. Expect that each patient visit will take longer, as the record will have a lot of blank spaces to be completed. Patient loads can be half of the normal number, so select a slower time if possible.

Conversion of Paper Charts (Preloading) 

Preloading involves the transfer of clinical information from a patient’s existing (often paper) chart into an Electronic Medical Record (EMR). Preloading historical data from the patient’s chart into the EMR can help ensure that relevant clinical information is available easily to the care provider at the first clinic visit. Common information preloaded into the EMR includes allergies, medications, preventive care documentation (e.g. prior mammograms, colonoscopies, immunizations), and recent laboratory tests and vital signs. Staff members already familiar with the existing paper charts may more easily find and extract relevant data, although personnel with some health care experience, such as billing coders, medical record specialists, health science students, or health professionals may be readily trained to perform this task. Providers using the EMR may find it useful to preload a small number of charts during their training process to help familiarize themselves with important functions of the EMR.

Go Live

The installation of hardware and software may be done by vendors or the practice may do the installation themselves. Determine what support will be available on that day and how providers will get immediate help. Plan for the worst case and try to have contingencies for anything that can go wrong.

Complete Implementation of the EHR

Installation does not mean the EHR is fully implemented. Using the new system in a meaningful way is needed and that’s where CHITREC can help. A failure to manage the changes to the practice can lead to an unsuccessful implementation, with unhappy staff members, unpaid claims and disgruntled patients.


CHITREC implementation managers are available to help with any or all of these steps.