Effective Deployment of an Electronic Health Record (EHR) in a Rural Local Health Department (LHD)

Issues: A small rural local health department (LHD) implemented an Electronic Health Record (EHR) using a step-by-step implementation guide. The project incorporated national standards and requirements to meet Stage 1 Meaningful Use criteria under the HITECH Act (2009). Description: The LHD formed a 7-member multidisciplinary team with defined roles and responsibilities to prepare for EHR implementation. The team collaborated with the West Texas Health Information Technology (HIT) Regional Extension Center (REC); attended a regional conference on EHR meaningful use, clinical decision making (CDS), quality, and safety; reviewed the LHD's services, payor and funding sources, current charting and billing systems, perceived benefits of EHR implementation; and developed the vision, goals, and criteria for the project's success. After EHR vendor training the LHD went live in September, 2011 employing a Big Bang approach. Lessons Learned: A proactive multidisciplinary team approach is essential for implementing an EHR in a small LHD. Collaboration and consultation with a regional REC and local public health funding sources was essential to provide expertise and implement a meaningful EHR applicable to the setting. The EHR can impact prevention and wellness across the lifespan by providing accessible preventive health services documentation, CDS, and has eliminated paper charting by 98%. Recommendations: Successful EHR implementation and use include: utilizing a step-by-step process, matching the capabilities of the EHR selected to the staffs' perceived benefits; redesigning workflow with an improvement focus; and ensuring flexibility and capacity for creating documentation components within the EHR.