By Stephen Aleksza, PMP | Post-Acute EHR Advisory | In Partnership with HealthTECH
This article is part of our Expert Insights series, where experienced healthcare IT consultants share practical perspectives from real engagements.
Stephen Aleksza, PMP is a post-acute EHR advisor with nearly 30 years of vendor-side experience at Netsmart, Allscripts, and their predecessor platforms, where he led product management and professional services for home health and hospice. He partners with HealthTECH to help hospice, home health, and palliative care organizations navigate EHR selection, optimization, training, and migration.
The project plan states that your clinical superuser is assigned to the EHR implementation. It doesn’t say they still carry a full caseload and take call every third weekend. Most agencies build their project teams this way, and the work ends up on top of the jobs their best people already hold.
On the vendor side, I saw the same project plan play out very differently from one agency to the next. The hours in the resource plan rarely matched what people could actually provide. The agencies that did well treated staff time as a real project cost and planned for it before kickoff.
Count the hours before you assign the people
Vendor project plans typically estimate the client hours each role will require. Compare that estimate with what the person already does in a normal week to see what’s left. If a project team member has four open hours a week and the plan calls for ten, that gap needs to be addressed.
Put backfill in the budget
EHR proposals cover the vendor’s licenses and services, but they rarely show the cost of covering your own people. Agencies that plan well fund per diem or temporary help for the heaviest months before go-live. Without that line, the agency still pays through overtime and slower decisions, and a CFO would rather see the cost in the business case.
Protect specific days
Saying someone is 25 percent dedicated means little when the census spikes. Specific project days hold up better because everyone can see when those days are pulled away. Decide up front who will handle the person’s regular work on those days, so that time stays protected when things get busy.
Decide what stops
Backfill and protected days only go so far. The next step is strategic subtraction. Before kickoff, executives should identify routine work to pause, such as non-regulatory audits and standing committee meetings. When they announce the pause publicly, the project team has both the authority and the psychological permission to let that work go.
Let the people doing the work shape how it’s done
Lean thinking holds that the best ideas for improving work come from those who do it every day, so the department representatives on the project team should have a real say in how the new workflows are designed. Each department still needs a leader who sets the project strategy and communicates it to the department’s representative. That leader also makes tough calls and breaks logjams when the team gets stuck.
Plan the way back
Project teams often return to full duties the same week the harder questions start. Decide before kickoff how much protected time they will keep for the first 30 to 60 days after go-live. That keeps the people who know the new system within reach of the staff who are still learning it.
If go-live is going to happen on schedule, those hours have to come from somewhere.
How did your agency cover the day jobs during its last implementation?
From the vendor side
I spent nearly three decades at Netsmart and Allscripts, including years running professional services and implementation teams. If your agency has an upcoming implementation, I’m glad to review the staffing plan with you before kickoff. Reach out here:
