Title : Leveraging change management for a successful EHR migration in correctional health
Abstract:
Effective change management is essential when transitioning from one Electronic Health Record (EHR) system to another, as it helps reduce clinician burnout and fosters trust in technology (Huang et al., 2020). To align Correctional Health Dallas County with the enterprise system at Parkland Health, a structured approach incorporating multiple change management strategies was implemented. Before initiating any training, the lead Clinical Informaticist—a nurse practitioner—immersed herself in frontline care by working clinical shifts within the Correctional Health facilities. This hands-on approach enabled her to gain firsthand experience with the existing EHR, anticipate potential implementation challenges, and establish rapport with staff. In addition, members of the Clinical Informatics Learning Team conducted rounding focused on understanding current workflows and listening to staff concerns. These proactive efforts fostered trust and credibility, laying a strong foundation for the upcoming transition. Key change management activities included securing buy-in from nursing, medical, and operational leadership, conducting regular rounding to discuss the new system, and understanding current workflows and user roles to anticipate changes. Concerns about job security, particularly for roles such as Health Unit Coordinators, were addressed early to minimize resistance. Building relationships with end users prior to implementation and creating a detailed crosswalk comparing current and future processes were critical for transparency and trust. Training initiatives were extensive and multifaceted. These included Epic demonstrations, road shows, and “Day in the Life” (DITL) sessions to simulate real-world use. Super Users were identified and trained to provide peer support, while pre-education and early system access allowed staff to gain familiarity before go-live. Post-implementation support continued through ongoing training and group Q&A sessions to reinforce learning and address emerging challenges. While the go-live was not without obstacles—such as technical issues during training, staffing shortages that limited participation, and a reduced Clinical Informatics presence that delayed incident resolution—the impact of these challenges was significantly mitigated by the change management strategies employed. Early engagement, relationship-building, and comprehensive training created resilience among staff and promoted confidence in the new system. This experience illustrates that although perfection is rare in complex EHR migrations, effective change management can transform potential disruption into a smoother, more successful transition.
