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Beyond implementation: ensuring EHR success through engagement

by Gary Mooney, clinical solution executive, InterSystems

The implementation of Electronic Health Record (EHR) solutions often requires healthcare institutions to invest substantial time and resource up front, as well as making a significant on-going budget commitment.

Yet, EHRs also promise to enhance service performance and establish a digital foundation for the integrated models of care that can meet modern demands. EHR deployments however that focus only on factors such as installation, configuration, training, and go-live run the very real risk of suffering poor user adoption and ongoing broader customer dissatisfaction. Healthcare institutions need to look beyond just implementation if they want their EHR to be a success.

Ensuring effective user engagement

While functional capabilities are important, they do not, by themselves, guarantee a successful EHR deployment. KLAS Research has reported research data that shows a widespread perception of EHR success for the same version of an EHR solution, with some organisations reporting significant benefits and outcomes, whilst others describe ongoing challenges and unhappiness with their EHR. Notably, KLAS Research data on the ‘Satisfaction Discrepancy for the same EHR solution’ shows a 62% difference in satisfaction between two organisations using the exact same EHR solution.

When a new system is introduced without meaningful participation, staff may struggle to see its relevance or understand how it will affect their workflows. While organisations typically have the authority to determine and demand the systems staff use, top-down mandates often encounter obstacles within the multifaceted structures commonly found in healthcare.

User engagement is crucial in being able to communicate the value of the solution and to gather insights into the ideas, concerns, and expectations of users throughout this process. Done well, it involves tailored communication strategies for different groups, including clinicians, managers, and administrative staff, to ensure that each stakeholder understands how the EHR can enhance patient care or streamline operations.

However, user engagement should not devolve into endless software redesign. The system’s capability to meet organisational needs should have been validated during procurement, and extensive reengineering after purchase can lead to excessive costs, schedule overruns, or failure.

An effective engagement plan helps staff take ownership of the EHR. It encourages early buy-in by involving them in conversations about how the technology will be integrated into their workflows, rather than imposing decisions without explanation. When staff feel that their perspectives matter, they are more likely to see the system as an essential tool and to promote its benefits to their colleagues.

The plan also demonstrates tangible value by closing the feedback loop. When frontline staff observe that their input leads to meaningful system adjustments or process improvements, they perceive the EHR as relevant to their tasks. This sense of relevance becomes a foundation for sustained adoption and reinforces a culture that embraces ongoing innovation and change.

In addition, an engagement plan highlights the importance of training and onboarding. Training sessions become more effective when they address specific day-to-day processes rather than relying on generic system overviews.

By aligning training materials with user profiles and responsibilities, staff can quickly grasp how the EHR impacts each step of their workflow. This alignment promotes confidence and comfort, reducing resistance and paving the way for a more productive implementation. Ongoing support further solidifies learning. Regular reviews, refresher instruction, and accessible resources help sustain momentum after go-live.

Articulating solution value

Effectively articulating solution value in terms that resonate with different user groups is essential for a successful engagement programme.

EHR and digital adoption programmes often express value in relation to corporate-level benefits and outcomes – commonly those identified to support a business case. This can leave users to interpret how these benefits apply to their roles, leading to confusion, misalignment, or disengagement—creating barriers to adoption.

Persona profiles provide a valuable reference point for determining communications (content and format) with groups of healthcare professionals, to express solution value in terms that resonate with their professional responsibilities, while forming the relationship to be able to refine and define the value of the solution for their persona group. As such, persona profiles can provide a valuable tool in supporting the broader change management workstream and paving the way for positive user adoption from go-live.

A well-defined persona profile is essential for tailoring communication to healthcare professionals, ensuring that solution value aligns with their responsibilities and needs. Key elements include role profiles, goals, challenges, motivations, technology usage, communication preferences, and a clear articulation of the solution’s value. These profiles support effective change management and foster user adoption.

Establishing a clear “true north” is equally crucial for a successful EHR implementation. A well-structured vision aligns digital transformation with strategic objectives, emphasising patient-centric care, leadership commitment, innovation, data-driven decision-making, and regulatory compliance. This vision shapes both engagement efforts and the broader implementation strategy.

Measuring adoption requires both quantitative and qualitative insights. Real-time usage data from reporting dashboards helps track engagement, while surveys and observational studies provide a deeper understanding of user experiences. This combined approach ensures that adoption challenges are identified and addressed.

Long-term success hinges on sustained user engagement. A well-executed plan fosters communication, trust, and alignment with clinical workflows, ensuring the EHR remains a valuable tool for staff. By prioritising engagement and ongoing support, organisations can drive adoption, improve satisfaction, and enhance patient care outcomes.

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