2 Rollout and Turnover Strategies

Section 2.12 Plan

Section 2 Plan—Rollout Strategies - 1

Rollout Strategies

Organizations might roll out clinical information system applications in a number of ways. This tool describes how an application may be rolled out in multiple locations, as well as ways to transition individual users.

Time needed: 4 hours
Suggested other tools: Section 2.4 Visioning, Goal Setting, and Strategic Planning, Section 4.8 Change Control, Section 4.14 Training Plan

How to Use

1. Review the different strategies and decide which apply to the application you are implementing. Different strategies may apply to different electronic health record (EHR) and health information exchange (HIE) applications.

2. Plan the rollout when you are planning for the implementation, because many users get very concerned about when and how a new application will be rolled out.

3. Recognize that turnover and roll out strategy differs from the chart conversion/pre-load strategy (see Section 2 .13 Chart Conversion and Pre-load Planning), which describes how previous records will be used with/integrated into a new EHR.

Turnover Strategy

Turnover strategy refers to how one an application will be implemented throughout multiple locations.

Type of Turnover / Consider Using if Organization is:
Straight turnover
· One or more applications are implemented and paper processes cease upon or shortly after go live for that application / o Large and small organizations that are relatively new to computerization
o Suitable for clinical applications where duplicate (paper and electronic) processing is subject to error and too time-consuming
Parallel processing
· An application is implemented, and
· Paper processes continue until system works as planned / o Small organization new to computerization
o Implementing a product new to market
o Implementing a patient accounting or other system where there is a need to compare results between old and new system
o Generally not suitable to clinical systems where duplicate (paper and electronic) processing is subject to error and too time-consuming
Phased turnover
□ Application of straight turnover or parallel processing (generally with only one or a few applications) to one or a few organizational units at a time / o Multi-facility
o Multi-departmental facility with disparate systems
Big bang turnover
□ Implementing all applications in a straight turnover mode to all organizational units at one time / □ Organization experienced with computerization
□ Limited scope of applications

Rollout Strategy

Irrespective of the turnover strategy, you may need to transition individual users from using paper, through various stages of using any given application, and ultimately to full adoption of all components of the new information system application. Various strategies, which are not mutually exclusive, may be used for transitioning. These strategies are not mutually exclusive:

· Retrieve data. If the system is set up so you can have users retrieve information from it prior to them being expected to enter data, this can help users who are new to computers reinforce their newly learned computer skills and become interested in using the system for other purposes. This may apply to retrieving documents that have been electronically fed or scanned into the system, such as referral documents. It may be feasible to do this for two or three months while the rest of the system is being customized for the organization. This may also apply if implementing both EHR and HIE—where data are retrieved through the HIE as a first step.

· Enter limited data. If the EHR application includes several modules, you may want to have new users enter data into only one module initially. This module should be as stand-alone as possible, where absence of other data won’t be a burden or pose a safety risk. It should have as few differences from the paper as possible (e.g., already using a flow sheet) and demonstrate value for the staff (e.g., provided reminders).

· More sophisticated data retrieval and entry. The final phase is to have staff enter all other data, including where a template must be followed that may branch to alternative screens, or where narrative notes must accompany some of the structured data entry. This might also include receiving data pushed from an HIE that the user must take action upon when received.

Section 2.0 Plan—Rollout Strategies - 2