Send out an RFI and an RFP. Dolphin advocates presenting your questions to vendors in an RFI, or request for information document. Here, you can present to vendors all your unknowns in an orderly fashion, as well as any scenarios unique to your practice. “Once we received [the RFIs] back, we rated [the vendors],” she says. “We selected five for RFPs [request for proposals] and started what we called the ‘dog and pony shows.’”

Advice to the upgrade-worn

If you’ve chosen wisely, your vendor will be an invaluable partner during your transition, as long as you both firmly commit to a high level of communication. “You need a project manager who can appropriately communicate with the practice and the vendor,” says Stinson. He recommends establishing an implementation team that develops a project timeline and facilitates weekly or even daily update calls between vendors and practices. Also, expect the upgrade process to take some time — a minimum of one week, and perhaps up to 10, depending upon your practice size and needs. But if you’ve done all your homework, it shouldn’t be a traumatic affair.

Still, heed these hints and advice tidbits from those who’ve been there:

• Train your staff twice. Blair noticed that his staff was floundering somewhat several months post-implementation, especially the veteran billers. This came from their deeply embedded knowledge of “the old way” of doing things. A session of advanced training, concentrating on tips and tricks to navigate the system more nimbly, helped get them back on track.
  
  
• Insist on user compliance. “Some people got overwhelmed at the ‘go-live,’” says Blair. So instead of following the procedures and protocols they had just learned in training, they “set that work aside — and that becomes a habit.” Keep encouraging consistent compliance; it will come.
  
  
• Reward positive behavior. Jenkins provided fun incentives to encourage positive attitudes toward training, including points-for-progress drawings. She even awarded coffee mugs depicting a woman in the midst of a hot flash that read, “I’m going through the change at OB/GYN Associates.” Jenkins says, “Even though they were supposed to do it, they were rewarded for it.”
  
  
• Barter your tech support. OB/GYN Associates is “on the team that [the vendor] can use us as a ‘site’ visit,” Jenkins says, meaning another practice may stop by for a demo. “So I insist we be as up-to-date as possible, and we get a discount on our support contract.”
  
  
• Consider scrapping your legacy data. Why would you do this? All that information, seemingly wasted. “Because it gives the practice a chance to clean up its data,” says Blair. “We had 88 ‘Aetnas,’ all with the wrong address.” Be honest with yourself: Are the data worth cleaning up, which, if outsourced, could cost $10,000 or more? Re-entering as patients come in takes some time, but the data will be much more reliable.
  
  
• Create or join a user group. There’s nothing like a good discussion over an issue of common interest. “Not everybody asks the same questions in their RFIs,” says Dolphin. “You become more informed: ‘How do you do this? How do you solve that?’ California is a different beast, although I’m sure every state has its beast.”

Any major shift in a practice’s paradigm dictates that everyone involved be on board to ensure success. Foot-draggers can really sap the positive energy flow from everyone else. But with patience, calm insistence, and positive feedback, you can win over the most stubborn holdouts. Jenkins had one such case — a seasoned employee who kvetched bitterly about the new software, insisting she could never master it. But then Jenkins came in late on a day a site visit had been scheduled by another interested practice. “By the time I got here, she had done the whole tour. She’s the point-and-click queen now,” Jenkins chuckles. “When the person who’s been here the longest and fought me the hardest does the tour, that really warms my heart.”

Shirley Grace, senior writer for Physicians Practice, holds an MA in nonfiction writing from The Johns Hopkins University. Her articles have appeared in numerous publications, including The Washington Post and Notre Dame Business magazine. She can be reached at sgrace@physicianspractice.com.

This article originally appeared in the February 2007 issue of Physicians Practice.