EHR System Implementation & Management 5 — Questions and Answers
Question 1: Which factor is MOST critical to sustaining EHR adoption long-term after go-live?
- Freezing all system changes for 12 months post-launch
- Ongoing training, continuous optimization, and responsive support structures (Correct answer)
- Replacing the system every 3 years
- Limiting EHR access to clinical staff only
Correct answer: Ongoing training, continuous optimization, and responsive support structures
Long-term adoption depends on continuous training, system improvements, and support that addresses evolving user needs and workflow changes.
Question 2: A 'build environment' in EHR implementation terminology refers to:
- The physical construction of the data center
- A non-production system instance where configurations are created and tested before being moved to production (Correct answer)
- The vendor's software development team
- The financial budget allocated for implementation
Correct answer: A non-production system instance where configurations are created and tested before being moved to production
The build environment is a separate system instance (non-production) where the EHR is configured and tested before changes go live.
Question 3: What is the primary purpose of 'user acceptance testing' (UAT) in an EHR implementation?
- To test server hardware capacity under peak load
- To have end users validate that the configured system meets clinical workflow requirements before go-live (Correct answer)
- To verify that vendor invoices are accurate
- To confirm that the EHR meets federal billing regulations
Correct answer: To have end users validate that the configured system meets clinical workflow requirements before go-live
UAT involves end users testing the system against real-world workflows to confirm it meets requirements before the system goes live.
Question 4: Which of the following represents a key risk of 'big bang' EHR implementation?
- Extended period of dual system maintenance costs
- Simultaneous system-wide disruption with limited ability to fall back if issues arise (Correct answer)
- Slow adoption due to only partial deployment
- Difficulty comparing vendor products after selection
Correct answer: Simultaneous system-wide disruption with limited ability to fall back if issues arise
Big bang rollouts switch all departments simultaneously, meaning any critical failure affects the entire organization with limited rollback options.
Question 5: In EHR change management, 'change fatigue' among clinical staff is BEST addressed by:
- Accelerating the implementation timeline to minimize disruption period
- Prioritizing changes, communicating rationale clearly, and pacing upgrades to allow staff recovery time (Correct answer)
- Delegating all change decisions to IT without clinical input
- Freezing all EHR updates for one year
Correct answer: Prioritizing changes, communicating rationale clearly, and pacing upgrades to allow staff recovery time
Managing change fatigue requires strategic prioritization, clear communication, and pacing updates so staff can absorb changes without becoming overwhelmed.
Question 6: When a clinical decision support (CDS) alert fires too frequently for low-risk situations, resulting in clinicians ignoring all alerts, this is known as:
- Alert downtime
- Alert fatigue (Correct answer)
- Alert mapping failure
- Alert governance breach
Correct answer: Alert fatigue
Alert fatigue occurs when excessive or low-value alerts cause clinicians to habitually dismiss them, potentially missing clinically significant warnings.
Question 7: Which governance process ensures that EHR software patches and updates are evaluated, tested, and scheduled appropriately?
- Incident response planning
- Change control process (Correct answer)
- Data retention policy
- Workforce training curriculum review
Correct answer: Change control process
The change control process provides a structured approach to evaluating, testing, approving, and scheduling all system changes including patches and updates.
EHR System Implementation & Management 5
Which factor is MOST critical to sustaining EHR adoption long-term after go-live?