The Next Time

Eric Grunden

Best Practices for Changing out a Failed EHR System

If you are anything like me, you find yourself daydreaming from time to time, when you should really be focusing on the task at hand or that project due at work.  It is human nature for us to “zone out” every once in a while and allow our mind to wonder into a land of “what ifs.” Yes, I’m as guilty as the next guy and often catch myself thinking about the beach vacation I would love to be on, or car I would like to have next, or what retirement life will be like, or what it would be like to go to the Super Bowl, or wondering why McDonald’s doesn’t sell hot dogs, or what I would change if I was the President (of the United States – not Greenway-it’s in good hands).

And if you are lucky enough to be married you can really amp up the “dreams” by co-dreaming with your spouse.  For my wife and me it usually revolves around our “next home.” For Nicole (my wife) our “next” home will have more closet space, larger breakfast area, an island in the kitchen, no formal living room or sitting area, more storage space in the attic and/or garage, a larger guest bathroom, a larger master bathroom, a larger walk-in closet in the master bedroom and a basement.  As for me, I’m a little less complicated – just a large basement with a movie theater room and a place for a golf simulator/trainer.

Yes, “the next time” conversations are a lot of fun to have, but can they translate into reality when the time comes – when you are actually ready to pull the trigger and make the move?  Which brings me to the subject of this post…

A recent KLAS report, Ambulatory EMR: Win Rates, Replacements, and Provider Loyalty, stated that 35 percent of providers are looking to replace their existing EHRs.  Additionally, it was reported that more than 40 percent of groups with more than 100 physicians were changing EHR systems. The industry is identifying this trend as “rip and replace.” So it seems that many practices today are starting to pull the trigger on “the next” EHR solution. Apparently there are needs, service requirements and functionality not being met by some of the solutions on the market today.

Most practices state that their reason for moving to a new solution was either due to lack of needed functionality, lack of product flexibility, issues with customer support and/or implementation/integration failures.

For customers who have made the decision to “rip and replace,” there is always a mixed bag of emotions that accompany it.  Of course there is excitement in moving to a solution that will address the needs/desires, but there is also always some trepidation because of the move from the known to the unknown – better said – CHANGE is never easy.  Many practices assume it is as easy as installing the new software and copying the data from their existing EHR to the new one.  And yes, that is definitely part of the process, but there is much more to consider and plan for with the move.  Here are some of the things we walk our customers through:

1. Project Planning – you don’t often get too many complaints for “over communicating”, so putting a plan in place that includes regular communication and updates to the staff AND patients is key.
2. Data Migration – what data will be transferred from the legacy system and in what format?  The goal is to capture as much discreet data as possible to ensure the continuity of the medical record and clinical reporting.
3. Training, Training, Training – Get your staff plenty of training, and then get them more.
4. Be flexible and expect obstacles – have a backup plan and communicate that plan throughout the practice.
5. Map out the workflow before you go-live – even consider running a mock clinic or test before go-live.  The providers should be intimately involved with designing the templates and mapping out the workflows within the clinic.  This will help to ensure full physician adoption. Bottom line – have the physicians invested their time!
6. Monitoring – once the onsite support and training team leaves make sure you have a dedicated team from the vendor to “watch over” your progress.  This will identify gaps in knowledge, suggest workflow improvements and act as an insurance policy for the billing department.

So if you are dreaming about your next EHR solution it is important to know exactly what you want from it before pulling the trigger.  And once you do make the decision to “rip and replace” make sure you have a good partner with a good plan and plenty of experience in doing these transitions.

Happy New Year & Happy “Daydreaming”!

Thanks and God Bless,

E

Follow me on twitter @EGrunden

To learn more about replacing your EMR/EHR, visit http://www.greenwaymedical.com/solutions/replacing-your-emr-ehr/.

‘Tis the Season…To Tackle Industry Challenges

Eric Grunden

“It’s the most wonderful time of the year, with kids jingle belling and everyone telling you to be of good cheer, It’s the most wonderful time of the year”.

Yes, I think for most of us, that is one of our favorite Christmas songs (originally by Andy Williams, but done by hundreds of other artists through the years).  And it is that time of year again!  Time to deck the halls, wish everyone season’s greetings, pray for peace on earth, exclaim joy to the world and say good tidings to you.  It’s time for Santa and gift giving and card sending and candy making and family traditions.  And most importantly it’s time for remembering and celebrating the true reason for the season.

It is time to give thanks and reflect on the past year, and without a doubt, I am truly blessed.  I’m blessed with a wonderful loving family, good health and to work for a great organization with people that are the best in the business.  It is also time to wish others peace and joy, good tidings and prayers; which brings me to the reason for this post.

This is supposed to be a stress-free, happy and exciting time, but I’m not sure that is the case for physician practices today.  We are in a very turbulent time for the industry.  There is 5010, the year-end attestation for Meaningful Use funds, the coming of ICD-10 and the threat of major Medicare reimbursement cuts.  I would classify those as anything but “exciting” and “joyful”.

I have many friends that are physicians, and of course I know many more that are our customers, and each and every one of them went into medicine because they wanted to make a difference.  They wanted to serve.  They wanted to help people.  I think you will agree with me when I say, it is often a challenge for physicians to focus on the medicine, and care of patients, in today’s world.

What other industry or profession are you required to basically learn a foreign language in order to get paid?  Physicians must know CPTs, ICD9s, modifiers, HCPCs in order to bill for their services.  There is also HIPAA, understanding EOBs and the constant fight with insurance companies to prove that you, not only provided the service, but you provided the right service.  Add to all that sick, tired, impatient, nervous, anxious and scared patients.  Sound like the perfect job?

So here’s my Christmas wish and prayer – that doctors can get a break, take a breath and have a stress free holiday season.  I know it can’t be easy doing what they do every day; working the long hours so you and I can be cared for and healthy.  And for that I say “Thank you” from all of us at Greenway.  I also promise that we will continue to work with you, and for you, in order to make life a little easier.  We will work on your behalf in Washington, to innovate and provide better solutions and provide the best service in the business.

Again, from all of us at Greenway Medical, Merry Christmas!

Thanks and God Bless,

E

Follow me on twitter @EGrunden

To learn more about Greenway’s Client Services or what Greenway Client Services can mean to you click here http://www.greenwaymedical.com/service/client-services/.

Superhero Super-Users

Eric Grunden

As you may or may not know, I am the proud father of two great boys – Jack & Chase (aka Thunder & Lightning).  If you are a parent of a boy between the ages of six and 12, you will definitely understand what I mean when I say, “Superheroes are alive and well.”  This past summer I invested a considerable amount of money in the local movie theaters seeing some instant classics such as Thor, X-Men: First Class, The Green Lantern and Captain America. (You might even consider Transformers: Dark of the Moon too).  Now, don’t get me wrong, I am still a kid at heart and love a good superhero popcorn flick as much as the next guy, but my boys take it to a new level.  You can count on a reenactment of one of the epic battle scenes to play out every night right there in our den; and of course, the hero ALWAYS wins.  We have all the shirts, Happy Meal toys, stickers, theme songs, Lego creations and PJs associated with each and every hero.  And my wife and I love every minute – it is truly one of life’s greatest joys being a parent.

With all of this summer’s superhero attention, it has somehow made its way into some of our customers’ offices.  As you can see from the pictures below, they too, have caught superhero fever! And yes, before you all email me at once, I realize Darth Vader is NOT a hero in the truest since of the word, but you get my point.

So what does any of this have to do with service or implementing mission critical software you ask?  That’s easy – all practices need a superhero super-user!

Let me put it another way; for a business to invest thousands of dollars in software, hardware and services, and then NOT invest in making one of their employees a super-user is a mistake.  No matter how much training you invest in or how much ongoing support you contract for, you still need a “go-to person” for the day-to-day operations.  Now they don’t necessarily need to be faster than a speeding bullet! More powerful than a locomotive! Able to leap tall buildings in a single bound! But they should have some “super-human” characteristics.  To name a few: determination, courage, dedication, selflessness, perseverance and loyalty.  All of these traits are needed to lead a practice through the transition of an electronic health record. They will need determination to make the project a success, have the courage to face staff members who resist the change, persevere through the challenges with the project team and remain loyal to the business through it all.

Those that take on this role are superheroes in my book!

So if you are in the midst of implementing any mission critical solution – call on your superheroes!

Thanks and God Bless,

E

Follow me on twitter @EGrunden

To learn more about Greenway’s Client Services or what Greenway Client Services can mean to you click here http://www.greenwaymedical.com/service/client-services/.

Moments of Truth & Bucket lists

Eric Grunden

I think it goes without saying that most people have their “Life To-Do list”, also known as their “bucket list”. These are the events, activities, places, people and things we want to experience before we “kick the bucket” – a premise made even more widely known by the 2007 movie “The Bucket List” with Jack Nicholson and Morgan Freeman.

I, too, have my list (although not a complete list, since I add to it every day). Here are some of my “things to do”:

• Learn to speak Spanish fluently

• Take my mom to Australia

• Drive the Pacific Coast Highway in a convertible with my wife

• Work in a winery or brewery for at least a month

• Play golf at St. Andrews with my sons

• Stay in an over-the-water bungalow in Bora Bora with my wife

• Test drive a Lamborghini (too much trouble to own one)

• Watch the Texas Tech Red Raiders in the BCS National Championship game

• Go to the Super Bowl and World Series

• Attend a movie premier

You’ll notice that the last bullet is “marked off”, and yes, I have attended a movie premier – recently as a matter of fact.

I always thought my movie premier would be in Los Angeles at an action film starring Bruce Willis, Will Smith, Tom Cruise and Angelina Jolie – or maybe even the premier of “Star Wars” episode 7 or 8.  Never would I have imagined I would be marking off #10 on my list by attending an animated kids movie in Dallas, TX, but nonetheless, it is officially accomplished.

Yes, my wife and I had the honor of attending the “Puss in Boots” movie premier at the Gaylord Texan, hosted by DreamWorks Animation and Gaylord Entertainment.  The event was wonderful!  It surpassed our expectations by 1,000%, and will be something neither of us ever forget (see picture with Antonio Banderas below).

Puss in Boots Premier

In the spirit of full disclosure, Greenway has been in partnership with Gaylord Hotels since 2009, and we conduct the majority of our customer events at one of its properties.  We didn’t enter into that relationship lightly, but rather after an exhaustive review of many options and providers.

The main thing that drew us to the Gaylord team was their corporate culture and focus on the customer – something Greenway believes to the core.  I think it’s safe to say that both organizations give much more than “lip service” to customer care and truly care about the customer experience…something both companies refer to as “Moments of Truth”.

If you follow my tweets and blogs, you’re familiar with the term Moment of Truth because I’ve written about it before.  An “M.O.T” can be either positive or negative, but either way it will change the course of the relationship with the customer.  The result can be the much-wanted “Customer for Life” or the much-feared “Future Customer Killer”.

Customers can recognize service that feels manufactured and insincere; they know when employees don’t really care and are only doing a job.  True service isn’t forced; it isn’t manufactured and is 100% sincere – even awe-inspiring!  To deliver a Moment of Truth experience for customers, it has to exceed their expectations and be something they will never forget – something they will compare other experiences against.

I guess that’s really what we’re all looking for within our “bucket list” experiences.  But I think it’s a shame that we’ve had to resort to a special list in order to be truly wowed.  Just my opinion, but maybe we should start expecting those “Moments of Truth” more often…

Thanks and God Bless,

E

Follow me on Twitter @EGrunden

To learn more about Greenway’s Client Services or what Greenway Client Services can mean to you click here http://www.greenwaymedical.com/service/client-services/.

Encourage Customer-to-Customer Interaction

I apologize for the delay since my last post, but to say it’s been hectic lately would be an understatement. Don’t get me wrong – it is a great time to be at Greenway, but there is a lot going on.

On that note, we just concluded the largest PrimeLeader event in history!  For those of you unaware of what PrimeLeader is – well, it is only the best National Users Conference on the planet.  We had 1300 attendees converge on Atlanta  for four days of in-depth training, interaction with other customers and fun. It was truly a great event and great opportunity for customers to share their experience with Greenway as well as other customers. Which brings me to my topic for this post…

It probably goes without saying that all software companies spend significant amounts of time and money developing tools and strategies around delivering customer support. The quickest way to slow down sales, reduce bottom lines and tarnish a good reputation is to provide poor customer service. The old rule of thumb was that one unhappy customer would tell ten people about their experience. But in the world we live in now, with Facebook, MySpace, Twitter, texting, chats and instant email one unhappy customer could potentially reach hundreds or even thousands of people. So how is one to do it? How are companies today able to keep up with the growing demands of customers?

It starts with a commitment, and ultimately the commitment to do the right thing. Beyond that you can apply resources, cutting edge technology, learning systems and FAQs all in support of the customer’s needs, but there is “another level” companies should strive for – providing opportunities for customers to help each other.

It is a little concerning to companies to provide online communities and user groups. It does allow for customers to “vent” or share poor experiences. But if done with the right mindset and intentions, it can truly be beneficial. Customers helping customers by answering questions, providing advice and sharing experiences not only can reduce the load on a customer support desk, but can also provide great insight to what is working and not working within the organization. Additionally, customers often take feedback and ideas better from someone actually in their same position than they do from the vendor.

As a vendor we are committed to understanding our customers’ “experiences,” and want to create as many opportunities for customers to provide those experiences to us as possible. That can be done through National User Conferences, customer support desks or even online communities. So no matter what your job requires or what system you use – try and be a good neighbor and help another user when opportunity presents itself.

Thanks and God Bless,

E

To learn more about Greenway’s Client Services or what Greenway Client Services can mean to you click here http://www.greenwaymedical.com/service/client-services/.

System Replacement is Trending in the Industry: Avoid a Second-Time-Around EHR

I have been doing this “Healthcare IT” operations thing now for quite some time – going on 16 years, and I am truly amazed with how far this industry has come. Early on practices focused on automating the scheduling and billing functions solely. The likelihood of finding a practice even willing to discuss “EMR,” much less actually trying to implement one, was as likely as finding the Loch Ness Monster, a living breathing jackalope, or successfully capturing one of those “snipes” my granddad sent me hunting for.  Yes, the “market” was all about the efficiency and speed we could bring to an office in getting the patients in the door and the claims out. 

There was a lot of turnover back then as well.  It was not uncommon to speak to an office manager that had “installed” multiple Practice Management systems – each new system providing the practice with a new widget or promised “ease of use.” But at the end of the day, they all pretty much did the same thing – allowing for patients to be registered, scheduled and billed for services; all the time allowing clinicians to live freely in their paper world. 

Then, enter the EMR, and the initial wave of early adopters (a.k.a. techno-geek docs and bleeding edge physician offices). 

For the past few years we have seen very few customers “changing” EMR/EHR systems. The majority of our work (approx. 95%) has been with physician practices implementing for the first time. However, over the past 12 to 18 months we have seen the number of 2^nd timers increase dramatically – 30% of the implementations done have been with customers converting from another EMR/EHR solution.  A dramatic shift for sure! 

What we’ve seen are practices that chose their initial EMR/EHR solution based solely on price, or functionality or promise of “all the interfaces” needed. Many of these practices chose products with great features from sound organizations – so why change? Well, they found out that it’s not all about functionality and features. 

Implementing any mission-critical application has to be looked upon as “change management.” It would be my recommendation to all practices that you consider the following when choosing any software vendor (or better said – partner)…

1. Project Leadership – the project must have physician buy-in and leadership
2. Detailed Project Plans and Communication – have a plan and methodologies for communicating it to all staff
3. Don’t try and “re-invent” the software until you fully understand how to use it – Getting a vendor to make changes to the software before it is fully implemented and optimized sets you up for failure.
4. Training, Training, Training – Get your staff plenty of training, and then get them more.
5. Flexibility – choose a vendor with a flexible platform to ensure adoption by all physicians.
6. Don’t skimp on hardware – Don’t buy a Lexus and then try and drive it on bicycle tires – invest in quality hardware.

Luckily, our “2^nd timers” understand these and are widely successful in a much quicker timeframe.  They understand it is about functionality AND Service AND understanding workflows AND change management. 

Thanks and God Bless,

E

To learn more about Greenway’s Client Services or what Greenway Client Services can mean to you, click here http://www.greenwaymedical.com/service/client-services/.

How Do You Define Success?

As we are still very early and new to this “blog” thing, you would expect that I have lots of topics to discuss and comment on, but many of you will be shocked to know that I really struggled coming up with a subject for this post. Yes, that’s right, I had writer’s block. One would think that 10 days on the beaches of South Carolina would break the block and allow the words to flow, but alas, no such luck.  (It was a great vacation, though.)

Ironically, it was returning to the action packed days of Greenway that finally led me in the direction for this post. 

As many of you know, our annual national users conference, PrimeLeader is rapidly approaching (less than 70 days away)!  PrimeLeader is THE most important event we do all year. The event itself only lasts four days, but the planning, preparation, design and setup takes more than eight months – IT IS NOW CRUNCH TIME! The PrimeLeader team members are rock stars. Their ability to pull off the industry’s best user group meeting is truly amazing to watch. Which brings me to the subject of this post…

This year’s PrimeLeader theme is “Ensuring Success.” Of course with all the press and fever pitch around meaningful use, it’s pretty easy to see how we arrived at this theme. Not a day goes by without a customer or prospect calling me to ask how Greenway is going to “ensure” they meet all the criteria for meaningful use. Without a doubt our customers are positioned to achieve meaningful use – our products, services and support will ensure our customers are successful. But at Greenway – that’s not good enough. Why just “meet” meaningful use? Why not ensure MORE! That’s what this year’s PrimeLeader conference is about.

It’s important to understand that there is a difference between “going live” on an EMR and doing enough to achieve meaningful use, and “adopting” an EMR and using it to improve patient care and profit margins. I worry that practices will start to focus too much on the single go-live event and checking off the meaningful use criteria and not truly implementing an EMR throughout the practice – addressing workflows, physician-patient encounters and true performance metrics to measure success.

The great thing about PrimeLeader for our customers is that it provides the perfect continuing education event. The ability to interact with other users, attend in-depth and specific training sessions, workflow discussions and getting industry updates, allows our customers to be MORE successful. They are not just focusing on the initial training and go-live, but also investing in their adoption. 

If you would like to learn more about PrimeLeader and/or are interested in attending, please go to www.greenwaymedical.com/primeleader2010.

Thanks and God Bless,

E

To learn more about Greenway’s Client Services or what Greenway Client Services can mean to you, click here http://www.greenwaymedical.com/service/client-services/.

Flexibility and the Razor’s Edge – Eric Grunden

Well I am, without a doubt, very new to this whole “BLOG” thing – can’t say as I have ever even read one, much less written one.  On top of that my family assures me that there can’t be too many people out there that are interested in what I have to say.

To be honest though, I expected there to be more fanfare around the launch of my first official BLOG!  For those of you that know me, you know that I love to hear myself talk – and this BLOG thing is just another opportunity!  So imagine my surprise when I was asked to “add a few more paragraphs” to my first post. I was trying to pace myself I guess – rather than come out of the gates at a sprint I was going to start slow and take this first one “easy.” Now … not so much.

I want to start with a few guidelines for my BLOG in an effort to let you know what to expect from my posts.

1. Life is too short to take everything so seriously, so I will try and add some humor to my posts.  I think of myself as a funny guy; no guarantees you will though.
2. This won’t just be for Greenway customers. I want to share my thoughts and Greenway’s mindset on service and support in an effort to ensure everyone’s “experience” is a positive one.
3. My opinion … I’ve been doing this for more than 15 years now, so I have a few opinions on things and can’t wait to share them.
4. No guarantees around the “grammatical correctness” of my posts.  My wife, mother and sister are all phenomenal writers, so I expect to get plenty of critiques and corrections.
5. Subject matter – just about anything. Of course I will try to focus on training, implementation and deployment of “mission critical software,”  but don’t be surprised to see posts about college football, golf, politics, the weather, music, TV, movies or any other subject that might somehow tie into how Greenway focuses on service!

Speaking of service…

I thought I would start by ensuring everyone is familiar with what makes Greenway’s Client Services team unique. Our approach is focused on service, innovation, leadership and partnership.  This focus is in effort to ensure the success of our customers.  We understand we are only as successful as our customers. Whether you are a Greenway employee, customer, partner or prospective employee, we are committed to providing you with a positive and successful “experience.” Our client services team consists of resources that represent more than 850 years of combined experience in healthcare and technology.  While we are only as successful as our customers, the Client Services success is built around the knowledgeable and experienced resources that are part of this team.

Before I call this first BLOG complete, I want to share my first “tip” to anyone deploying a complex piece of software under the guidance of a professional services team.

I’m often asked what “complaint” I hear most from customers. This question usually comes from prospective customers, new employees or other shareholders. The answer is easy – it’s a tie.  First, “Greenway was too flexible.  I was given too many options for my implementation; too many different workflows or experiences.” Second, “Greenway was too rigid in how we should implement the functionality.  We weren’t given options during training.”  Crazy, huh?

So I will say this about communicating with a project manager or project team: be very specific during the project initiation and training events. When you want “options” or “experiences from other customers” from your trainer, ask for them.  When you don’t and it “must be this way,” make sure they know as well. All trainers, project managers and deployment specialists walk a razor blade between being a “trainer” and/or a “consultant.”  Most are qualified and experienced to be both,  you just need to decide when you need one or the other.

Thanks and God Bless,

E

To learn more about Greenway’s Client Services or what Greenway Client Services can mean to you, click here http://www.greenwaymedical.com/service/client-services/.

Eric Gruden

Vice President of Client Services

Eric Grunden spent nearly two decades in healthcare project management and administration before becoming Greenway’s client services vice president in 2004. For Greenway, he directs the implementation, training and deployment “go live” of the company’s range of technology solutions for a diverse customer base of nearly 30,000 providers in far-reaching specialties and practice settings.

“I’ve worked in this industry for a long time and see many organizations give lip service to customer care, but Greenway truly believes it. Don’t get me wrong, we are not perfect and have our share of struggles, but what sets us apart is the fact that we always make it right.”

No lip service that, as Grunden’s team has realized an unprecedented set of customer survey-driven industry KLAS awards in recent years: in three different categories in 2008 and 2009, and nine overall since 2004.

As a married father of two, Grunden perfects a fair amount of customer service at home, and is so sympathetic to service it’s been said he never sends back a suspect meal.

Here he blogs on trends and innovations in healthcare delivery models and customer expectations.