Five Pitfalls to Avoid in Your NextGen 5.9/8.4 EHR Upgrade | Part 2

#2: Getting Your Sandbox Playtime Wrong

So you’re preparing to test your NextGen upgrade in one or multiple sandbox environments before going live. That’s great. But if you don’t simulate an accurate representation of the real environment, you’re on a fast track to project failure. A recent market survey of IT leaders, performed by PMI, found that 55% of technology projects fail. As you sit and read this, do you have confidence that you are not part of that 55%?

Let’s take a brief but pointed look into the front/back end (eg. Practice Management), and the clinic (eg. EHR side).

First, on the Practice Management side, key workflows with multiple variables include: check-in / check-out, charge & payment entry, and reporting. Any and all of these workflows will likely change significantly with your NextGen upgrade. That requires training and time for staff to re-learn, or break (which should be found in testing) during the upgrade.

Secondly, on the EHR side, proper testing requires running through all clinical workflows for multiple test patients including new patients, established patients, post-op visits, and subspecialties (eg. General Opthalmology vs. Retina vs. Glaucoma). All have different workflows.

If the testing process lacks depth, you won’t know until you're live that your physician suddenly can’t document an injection because the template has an issue. As we can all agree, that’s the worst time to have such an issue. Also, you need to leave enough time between the test upgrade and the production upgrade to correct any issues or find workarounds for them. Particularly with workarounds, the timeline can get away from you pretty quickly causing costly delays and frustration for users.

Going back to our market data on project failure, it’s not surprising that too many organizations take the risk of executing an incomplete or shallow testing process. Many cite an already-overwhelming day-to-day work burden. Others claim they don’t have the resources to understand the potential infrastructure impact of the upgrade. Whatever the reason, it’s not worth the risk of the dangerous consequences the practice could experience, like productivity loss, revenue loss, data loss, or system loss.

So what’s the answer to prevent getting your Sandbox playtime wrong? Here’s your checklist:

  1. Get buy-in for the WHY from other leader stakeholders, even if you are the head honcho.
  2. Start early and take it slow. There is usually little reason to rush an upgrade.
  3. Create two “impact checklists”: one for the business and one for IT. Make sure your list covers all critical software AND infrastructure requirements.
  4. Identify and gamify multiple business and IT use case scenarios (as noted with a couple examples earlier in this post).
  5. If you and/or your IT leaders’ cups already “runeth over” from your day-to-day work, engage a qualified third-party team to manage the execution of the project.
  6. Measure the before and after impact on your checklist.
  7. Socialize the implications with key stakeholders for feedback and planning.
  8. Run it all over again, one more time, with the changes before going live. 

Get your sandbox playtime right. It’s worth it to be in in the 45% of projects that succeed. You will achieve safety in decision-making, a good look at the new functionality, and happy users who avoid the disruption of failure. Failure in your NextGen upgrade will be costly. Investing in doing your sandbox environment right is a relatively small and worthy use of your practice dollars.

Stay tuned for the next installment of Five Pitfalls to Avoid in Your NextGen 5.9/8.4 EHR Upgrade... #3: Failing to Properly Set Expectations for Clinicians and Business Users.


About the Author

Michael Patrick, President at Systeem

With more than 20 years of technology and technology sales experience, Michael has led Systeem’s operations since day one, connecting our clients with technology, processes and ideas that make their lives easier and happier. 

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