Tip Tuesday: Five Phases of an EHR Upgrade

By: Ross Allen
Date: April 18, 2017

Upgrading an EHR is a necessary and important process that helps to ensure the long-term success of your IT investment.  Upgrades can be required by your vendor for good standing or for support purposes, but your organization can also use an upgrade to increase productivity, functionality, usability, and end user satisfaction.

Whether you’re planning your first upgrade or optimizing an existing process, defining a comprehensive upgrade strategy will provide your organization the best chance of success while also keeping current projects on track. The strategy should follow a traditional software development model that includes plan, build, test, train and optimize phases which avoids common mistakes and potential problem areas.


When planning the upgrade, be sure to include operations on the timing and scope of the changes to account for other initiatives. Engaging operations generates additional input and helps build commitment to the goals. During this phase, determine the timeline and milestones of the upgrade, define the upgrade scope, prioritize goals and objectives, gather feedback from end users, allocate staff and resources, and review new features and functionality.

Your organization will also want to review hardware needs as this is a commonly overlooked part of the project. Procuring and testing hardware will impact the upgrade project budget and timeline. Working with technical experts to complete a hardware configuration plan will ensure that your hardware matches the requirements of your EHR vendor and organization.


Most organizations spend the majority of time and resources in the build phase during an EHR upgrade.  While many changes occur automatically, most features require analysis, customization, and operational input. It is imperative to bring in subject matter and system experts to review, prioritize, and build new enhancements that will bring the greatest value. Often organizations don’t review how new enhancements and features affect current workflows. Analysts should work with end users to ensure that changes improve workflows and processes rather than increase complexity.


The scope of upgrade testing will depend on the enhancements implemented but should incorporate end users, hardware, ancillary applications, and should include integrated or end-to-end testing. A common missed opportunity during an upgrade is allowing time for end user testing. Having end users test changes and new functionality can provide instant feedback and highlight potential problems.


Training for an upgrade is much different than training for an initial installation. Training should be focused on how users will be affected by the upgrade in each area, rather than a comprehensive overview of each workflow. Over-training for an upgrade can greatly impact budgets and organizational resources, so it is important to leverage tip sheets and computer based training when possible.


It is inevitable that a significant number of optional enhancements will be not implemented during an upgrade. Most organizations lose track of these enhancements over time and the system becomes out of date. To avoid this common upgrade trap, develop a post-upgrade optimization program that prioritizes and deploys features that are available, but not yet implemented. A common mistake post- upgrade is not gathering end user feedback to use during optimization. Utilizing end user feedback further improves the system and workflows while also improving end user satisfaction.

Upgrading your EHR is a challenging project that can have a substantial impact on staff and resource which can negatively impact organizational goals, projects, and other initiatives. There are challenges in all phases of an upgrade, but having a comprehensive plan and experienced staff can ensure that an upgrade is successful and impactful for your organization.

Avaap employs project managers, analysts, and EHR experts with vast experience in upgrading and improving EHRs. To learn how Avaap can help plan, staff, build, test, train, or optimize your EHR upgrade, reach out to our Clinical and Revenue Cycle leads, Steve Weichhand and Matt Curren, for more information.

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