by Darcey Trescone, RN

Over the years, I have observed that leaders of successful home healthcare agencies embrace the concept of team structure. Never is this more important than during high-level planning of the phases of a software implementation project.

Since an Electronic Medical Record system in the home care and hospice space is not "shrink wrapped" software bought off the shelf at your local Best Buy, it is critical that its deployment be done well, that it be configured to each customer's business needs. In part two of my series on software implementation, I offer a broad stroke outline for team structure, with a list of specific roles and responsibilities, that has been the foundation of successful software selections and implementations for many organizations I have worked with over the years.

Basic Team Titles and Responsibilities

Described below are roles you need to assign. This plan is based on experience with medium- to large-sized agencies so you will want to adapt it depending on the size of your organization and how complex a system you are deploying. At a minimum, you must have an internal champion, ideally a trained project manager, to oversee and coordinate activities of the team. You will also find it critical that at least one C-level executive sponsor accepts the responsibility to both oversee and encourage the team as well as support appropriate decision-making regarding how the system should flow to best fit your organization.


    • Defines/documents workflow and reports/BI/forms requirements
    • Accountable direct to Internal Project Manager and System Administrator role


Basic Implementation Phases with Roles and Responsibilities Defined

Every vendor will have its own implementation phases for system deployment. Having your own internal phases that your structured team pursues alongside the vendor will better prepare your organization for conversion to your new system.  Below is a recommended plan with roles and responsibilities in each that have been found helpful for organizations selecting and implementing new EMR systems.

  1. Ground Zero – Business Needs/Requirements
  2. Phase 1 – Functional Workflows and Detail Reports/BI/Forms Specifications
  3. Phase 2 – System Configuration
  4. Phase 3 – System Implementation
  5. Phase 4 – On-going System Maintenance


Ground Zero Phase…..Business Needs/Requirements - What does your business require from a new software system?

Roles and Responsibilities:

Business Need/Requirement Activities

If you complete this prior to system selection than you have a high-level plan for your implementation and you are on your way.  If this is not done prior to system selection than there is a risk that your recent purchase will not support your organization resulting in:

  1. work-arounds within and outside of your newly purchased system to meet your needs;
  2. custom work the vendor will need to do within your new system to meet the needs, which could delay the actual system implementation;
  3. cancellation of your new system contract to allow you to find a different system to meet the needs (most vendors offer a warranty period so pay attention to this clause in any new contracts you sign)

System Implementation Phase 1 – Functional Workflow and Detail Reports/BI/Forms Specifications

Hopefully, you have purchased your new EMR system and your team is excited to get it in place.  The focus of Phase 1 is to ensure that the requirements for your workflow from patient entry thru billing are defined and documented, along with any key performance indicators you need to manage your day to day operations.  Phase 1 is focused on turning your high-level plan into a more detailed outline of your organization's needs.

Basic Roles and Responsibilities

Functional Workflow Specifications – how will the system operate daily?

Detail Reports/BI/Forms Specifications – what deliverables do we need such as reports/BI and forms to manage our organization and present functional workflow?

You may find after Phase 1 is defined you could still end up with work arounds and/or custom work from the vendor but if Ground Zero was done well your present software selected should still be a good fit.

System Implementation Phase 2 – System Configuration

Phase 1 defines your business process workflow within the system which is required by your vendor to ensure the system is configured appropriately for your organization in Phase 2.

Basic Roles and Responsibilities:

System configuration

System Implementation Phase 3 – operations are converted to the new system

Phase 3 is the actual system implementation within your organization.  This is what you have been preparing for until now and the below is only broad strokes of what is required.  Your team will need to work closely with your new vendor in this phase.

Basic Roles and Responsibilities:

Operational conversion to new system

Phase 4: ongoing system maintenance

Many leaders do not consider Phase 4 as part of software implementation, but this is a mistake. This phase includes ongoing system support, maintenance and continual training after initial implementation. This is clearly your organization's responsibility but too many organizations treat it as an after-thought. These agencies will fall behind, resulting in poor future processes and inadequately trained staff to keep the system working properly.

Basic Roles and Responsibilities

On-going System Maintenance

As an industry, we spend a significant amount of our revenue and human resources on our EMR systems. By embracing some internal project management principles and adopting appropriate team structure, you can help to ensure your organization's success with your most mission critical software system, now and in the future.


By Darcey Trescone, RN on Thursday, May 31, 2018