Serving the home health, home care and hospice industry since 1999.

by Darcey Trescone, RN

Successful software implementations require three things: 1) appropriate due diligence during the purchasing phase to ensure the EMR fits your organizations needs, 2) strong leadership during implementation, and 3) an understanding that your organizational business flows will need to work within the system you acquired.

According to Wikipedia: "A product software implementation method is a systematically structured approach to effectively integrate a software-based service or component into the workflow of an organizational structure or an individual end-user."

The inverse of this is how I like to think of a strong implementation methodology. "How do we integrate our organizational structure and business workflows into this predefined product?" Software vendors in any industry design systems for the general market and not specifically to one organization. They also do not have employees on staff that understand your specific needs or business nuances.

As a leader, you should continually be thinking to yourself, "The vendor provides a guide and some resources, but they do not know my business or my people. What does my team need to do and how do I ensure this system is going to work here?"

Product that fits your needs

As consumers, we make a lot of assumptions when purchasing anything but, as home healthcare agency owners, assumptions can be detrimental to a new software implementation. If your due diligence during the purchase phase was top notch, then you already know there will be some unmet needs — no software application is ever a 100 percent fit — and that work will be required to bridge these gaps.

During system implementation is when a misfit between the system and your organization will become obvious. Clients continually hear me say, "There is no perfect system that will do everything you need or want. What is the 80% that is critical to your day to day operations?"  

It is the basic 80/20 rule. If the system can handle 80% or more of your needs without issue than it likely is a good fit. The 20% it does not handle will require changes to your existing business workflow or negotiations with the vendor for custom development work.

Again, the vendor's role is to guide you according to their system design, in which they are the experts. They do not know your 80/20 rule for system suitability. Your role is to ensure their system will work in your organization. This responsibility begins during the sales process and continues through your go-live date.

Leadership and Team

The vendor's implementation team is typically made up of a Project Manager who oversees multiple customer implementations and trainers at a time. Direction from the Project Manager is that they train according to design of the system unless instructed to do otherwise.

Traditionally, persons in vendor-assigned roles are not allotted time to redefine your workflows or to figure out what in their system will not work for you. If time for this close examination were truly baked into the system cost, chances are you would be paying a lot more money for vendor implementation services.

The vendor implementation team assumes you will be driving the software through your organization, and you will be making key decisions about how it is to be used.

Business Process that Blends

What was shown in the sales demonstration prior to purchase does not ensure your business processes blend well with the system you selected. In theory, it should work but until you are hands-on it is hard to tell.

It is important to test your critical, day-to-day operational processes in the system before accepting a production environment. You need to walk through your 80 percent of critical needs to ensure the system will work for you and that there is a defined plan for the 20 percent that is missing. If you skip this step, you are accepting the system as is. You are tacitly assuming responsibility should the system not meet your needs.

In addition, as your users go through training and begin to work in the system, take the time before your go-live date to ensure that everyone can get the information they need to do their job into and out of the system. 

The software vendor’s implementation personnel are the experts in the system you just acquired. Their expertise, however, is limited to guiding utilization of their system as it is designed. Although a valuable asset to your team, the vendor implementation team cannot ensure your critical, unique requirements are all met without your involvement and input.


Selecting the right EMR software for your unique needs is only the first step. The road from EMR selection toward effective EMR use passes through EMR implementation. Whether your vendor guides you through an expert or a mediocre implementation, your leadership and your team's involvement is critical to making it as successful as it can be. This involvement can be daunting, however, and many owners and administrators find it cost-effective to engage the services of an outside advisor. A consultant who specializes in acting as an intermediary between your vendor and your team can smooth out the rough spots and significantly improve the ultimate result. In my own consulting practice, I have seen firsthand the benefits of using third-party implementation assistance. 

Darcey Trescone is a Healthcare IS and Business Development Consultant in the Post-Acute Healthcare Market with a strong background working with both providers and vendors specific to Home Care and Hospice. She has worked as a home health nurse and held senior operational, product management and business development positions with various post-acute software firms, where her responsibilities included new and existing market penetration, customer retention and oversight of teams across the U.S., Canada and Australia. She can be reached at

©2018 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. One copy may be printed for personal use; further reproduction by permission only.