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U.S. Department of Health and Human Services
Health Information Technology and Quality
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How do you prepare for a system go-live?

While the entire installation process from determining the need to implement a new system is in preparation for go-live, making sure everyone is ready for the actual first day of live use of the new system or application is imperative.  When implementing a commercial solution, many times the vendor will provide a checklist for go-live preparation that can be modified to fit each organization's needs.  Otherwise, standard templates are available (see below).

Preparation for go-live should cover all aspects of the implementation with adequate time allocated for becoming familiar with the new tasks and support resources available during the entire period.  Prior to go-live, all EHR build should be tested to make sure it is complete.  All hardware, software, and interfacing should pass testing for any networking, connectivity or compatibility issues.  Backup and downtime procedures should also be checked.  Beginning approximately 2 weeks prior to go-live, staff will need to be trained in the application that they will be using and on EHR policies and procedures.  They should also have created usernames and passwords prior to go-live and completed a "patient walkthrough" to simulate an entire patient visit.  As the actual go-live day arrives, signs should be placed in offices and hallways to notify patients that the go-live is taking place and to request their patience through this process.         

Conducting a pilot can be an important step in preparing for a go-live.  The hospital, office or clinic should identify the pilot unit or department based upon readiness (as determined during the readiness assessment).  During the pilot, an organization can assess in a smaller, more defined setting whether the system is working as expected and what additional refinements in process are required to ensure a smoother transition to the new system.  During the go-live planning, it is important to outline how the pilot will be conducted as well as the expected outcomes.  Pilots are normally conducted for a well defined period of time during which an assessment can be made of whether the new system adequately supports various clinical processes, how usable the application is, whether additional training is required, what other policies and procedures may need to be developed and whether any refinement is necessary in how the application is currently configured.

After the pilot, the provider organization should take steps to minimize disruption to patient care.  A step-by-step implementation, rather than a big-bang implementation, can be less disruptive, but may require staff members to handle variations among departments and to learn interim workflows.  An additional concern is staff productivity.  The organization should set realistic expectations for a return to normal productivity as staff will need time to adjust to the new system.  To avoid a prolonged period of low efficiency, organizations should confirm that their staff is ready during the readiness assessment.

Organizations should also be sure that providers know who to contact when they have a problem.  In rural settings, providers may have a more difficult time hiring an IT support person full-time.  However, especially during the initial implementation period, employing a support person to manage the help desk is key to ensuring that the staff uses the system correctly.

Resources:

Developed by the Health Resources and Services Administration as a resource for health centers and other safety net and ambulatory care providers who are seeking to implement health IT.
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