| Implementing an EMR system within your practice | | | | more accepted. |
| is not as easy as taking the software right out of | | | | The last phase should be charting patient |
| the box and installing it. In fact, that is about as | | | | encounters with the templates that come with |
| far from the truth as to how the process really | | | | the program as many doctors find this part of |
| works. | | | | the process the most frustrating. If you |
| Implementing electronic medical records is a | | | | customize your templates, the key is to keep |
| daunting task for most practices and the federal | | | | them as simple as possible so that all parties that |
| government estimates that the EMR failure rate | | | | will be using them will be happy with the system. |
| tops out at 30 percent. | | | | The next critical step in the implementation |
| For clarification's sake, some of the failures are | | | | process is to make sure that everyone receives |
| due to software and hardware issues but most | | | | proper training and is comfortable using the |
| of the time; the problems are due to human error | | | | system. Someone who doesn't know how to |
| - poor planning, lack of communication, and poor | | | | navigate their way through a program with |
| training. | | | | confidence will likely abandon the system. |
| The biggest challenge with EMR implementation is | | | | You have to keep in mind that you will be |
| managing the people involved, not the actual | | | | working with people that have different levels of |
| software or hardware that is being installed. When | | | | technological skills. This means you are going to |
| you implement an EMR system in a practice, you | | | | have to assess the basic computer skills of |
| are basically asking the staff to learn new skills | | | | everyone in your practice. The key is to gear |
| and change their daily work habits. Change within | | | | EMR lessons to the lowest common denominator |
| a medical practice can be a challenging thing to | | | | so that no one gets left behind. If you don't bring |
| take on. | | | | everyone up to speed and get them on the |
| The first step in the implementation process is to | | | | same page, some folks may get left behind and |
| establish a project team. Who all is on your team | | | | be unsatisfied with using the system. |
| will obviously depend on the size of your practice. | | | | Once training is complete and your staff feels |
| If you are a soloist, you are technically the | | | | competent about using the system, it's time to |
| project manager although you may delegate | | | | migrate to using it on the job. If you decide to |
| some responsibilities to others. | | | | take the incremental approach, every newly |
| A project manager will also be necessary to | | | | introduced functionality will have a "go live" day. |
| coordinate the rollout with your EMR vendor. | | | | The key is to give each function a trial run ahead |
| Typically in a small office the office manager will | | | | of time before taking it live to ensure that the |
| play this role. Larger practices with several | | | | software and hardware are working. |
| physicians may need to hire a full-time project | | | | The biggest challenge of going live will be when |
| manager on a temporary basis or consider utilizing | | | | your practice switches from using paper charts |
| a consultant. | | | | entirely to using the EMR for charting patient |
| If you are a small office, it's critical that you | | | | encounters. The key is to plan ahead and go live |
| include everyone on the implementation team. If | | | | during a slower time of the year. |
| you don't include everyone on the team and | | | | During the first week of going live it's a good idea |
| exclude certain folks from giving their input, don't | | | | for your staff to meet frequently to discuss your |
| expect them to buy into using the EMR system. | | | | progress, identify problems and address any |
| In a larger practice, you'll want to get everyone's | | | | additional training needs. |
| opinion but you'll obviously have to limit your | | | | The biggest key to success when implementing |
| implementation team's size to maintain efficiency. | | | | an EMR system is to make sure your team is |
| It's critical that you recruit members to the team | | | | dedicated to achieving success and that everyone |
| from each department within your practice - | | | | is motivated towards achieving the same goal. |
| front desk, clinical, medical records, billing, and | | | | Make sure and set realistic expectations and |
| administrative. It's critical that you choose | | | | reward staff for meeting these goals. |
| individuals from each department that are | | | | Make sure and listen to all concerns and |
| enthusiastic about the project and open minded to | | | | complaints during the process and address these |
| change and recommendations. | | | | issues as they come up. People want to give their |
| When it comes to the time frame associated with | | | | input and feel like a part of the team even if they |
| rolling out an EMR system, there are typically two | | | | don't expect everything to go their way. Listening |
| approaches that are taken. The first is based on | | | | becomes an important skill when working with |
| the "big bang" theory, meaning on a single day | | | | doctors who are learning the ropes of a new EMR |
| you switch over to the new system and | | | | system. |
| immediately go live with it. The second approach | | | | Unaccepted adoption of an EMR system among |
| is incremental and consists of implementing | | | | doctors in a group can be a total failure, because |
| various features of the EMR system over a | | | | they end up with two parallel record systems - |
| period of six months to a year. | | | | one on paper, one electronic - along with two |
| The big bang approach allows you to implement | | | | different workflows. If this occurs, you can forget |
| your EMR system immediately and therefore | | | | about achieving that desired return on your |
| achieve a quicker return on your investment. The | | | | investment. The goal is to have a doctor that |
| down side to this approach is that it can create | | | | truly believes in the EMR implementation and have |
| total chaos and lead to such frustration that end | | | | him or her work with others that are skeptic in |
| users abandon the EMR system. | | | | order to get them on board with using the |
| Incremental implementation is generally easier for | | | | system. |
| end users to accept and adapt too. If the EMR | | | | The most important part of the implementation is |
| system has a billing and scheduling module, | | | | one hundred percent commitment through out |
| implement that first to make sure your practice | | | | the entire process. There will be times when the |
| will get paid. Then consider implementing | | | | work is hard and frustrating but in the end, once |
| e-prescribing and intra-office messaging. The idea | | | | the EMR has successfully been implemented and |
| is to implement the features first that are going | | | | accepted, the benefits received will far out weigh |
| to give your practice the biggest gains in | | | | the challenges that your practice had to over |
| efficiency. As end users begin to see the | | | | come to get there. |
| efficiencies gained, the system will widely become | | | | |