Implementing an electronic health record (EHR) software application is similar in approach to implementing other applications that are customizable off-the-shelf (COTS) applications. In a COTS implementation there is very little application development however, some companies will have requirements to include in the implementation (an example would be integration points with third party applications). Many EHR implementations leverage consultants or other vendors to assist in the selection of a software vendor and/or consultant will provide an implementation methodology support.

In most projects, the vendor’s project manager will work with a project manager or resource from the client to manage the project. Given the size of most behavioral clinics, it is better to defer to the client’s project manager regarding application configuration. It is highly recommended to use a standard configuration that the vendor uses out of the box. Defer to the vendor’s billing and clinical architects for configuration to the COTS application to go live as “vanilla” as possible.

As the project is nearing go-live, the employees of the behavioral health facility will need to prepare for organizational change. The new application will be different from the current application; which can be overwhelming to employees. People change slowly and at their own pace.

To transform the organization all employees will go through the five stages of change:

Denial

Change is inevitable in organizations. There will be some employees who will fight this sudden change in their environment through denial. This can be seen through push back on leadership, especially if there are signs of weakness.

Anger

Following denial (or even sometimes the first emotion presented through this change), is anger. Anger can be displayed verbally, non-verbally, and in some cases, physically. The reaction is based on the cognitive thought- why is this happening to me?

Bargaining

Throughout this change process, bargaining can also appear in employees. Not wanting to completely make the change, they will try to find ways to negotiate or only put in half to little the effort to unknown change. Depending on the organization, this is a crucial stage where leadership will need to delicately guide their employees to embrace and adapt to the change.

Depression

Depression usually follows, especially when bargaining- their last hope to stick to their old ways, fails. This time can range from a few hours to months. Leadership should keep a close eye on all employees who are affected by the change, especially in the results of their work. Positivity and reassurance play a huge role in this phase.

Acceptance

The last and final stage is the emotion that all leaderships hope their employees will achieve- acceptance. This final stage shows the acknowledgment of change is present and employees have or are adjusting their work environment to this change.

Overall, change regarding any time of business or environment is difficult. Some employees will work their way through the five stages, others will not. Ultimately, leadership should be aware of all their employees and their coping mechanisms through the process.