You should start electronic health record (EHR) implementation planning as soon as you complete the practice readiness assessment and decide to adopt an electronic health record. Planning draws on information gathered during the assessment phase to outline the practice’s implementation plan.

You should identify staff members who will participate in setting up the EHR system. A strong project manager who will be responsible for development and execution of a comprehensive project plan based on the EHR goals and objectives of the practice is an important member of the team. Once an effective implementation team is established, the team should begin identifying the needs of the users to get a sense of how the EHR will be used in the practice. Often, EHR implementation results in making changes to the practice; in some cases the change is significant.

Planning becomes critical not only for identifying the right tasks to perform and the order of those tasks, but also for communicating to the entire team the transition to health IT. One effective first step in the planning process is for the team to segment tasks into three categories:

• What new work tasks/processes are we going to start doing?
• What work tasks/processes are we going to stop doing?
• What work tasks/processes are we going to sustain?

The start/stop/sustain exercise helps clarify what the new work environment will be like after the change and helps the team prioritize tasks in the overall project plan.