Since it’s the weekend, I like to open it up for the readers of this site to share their knowledge. Let’s hear the best advice you could give to someone who is implementing an EMR.
I’ll admit that I had a hard time just choosing one piece of advice. My first thought was mapping your current workflows and map them to your EMR software. This is an amazing way to plan for an EMR implementation. Then, my next thought was to choose the right EMR. However, that just feels too easy. So, I’ll take…
Make sure you get buy-in for your EMR implementation in all parts of your organization. Beg, borrow, steal, mandate, grovel, or whatever it takes to get buy in before you implement an EMR.
Get Fresh Healthcare & IT Stories Delivered Daily
Join thousands of your healthcare & HealthIT peers who subscribe to our daily newsletter.
You certainly picked a good one as your choice: buy-in is key. But, I’ll opt for gradual implementation. It will be disasterrous if you just turn on the switch one day to all the features of your new EMR and expect to just deal with problems as they come up.
The best things to choose from to get up and running first are scheduling, billing, and a faxserver. The rest you can phase in over time. Especially in the U.S., billing can be messy compared to here in Canada where each province has essentially one payor. With scheduling up and running and implementing a fax server, this will help with the buy-in since your team will see things that actually help them on a daily basis. The scheduling has its obvious benefits but the faxserver may only be appreciated once in place. All incoming and outgoing patient correspondence are available on-line and linked to the patient record…no more trying to file faxed documents into the correct charts…someone in your office just imports it into that patient’s record upon receipt.
So gradual implementation including a faxserver very early is my single most important tip of the day!
CEOs and other deciders live with the necessity of acting when the situation calls for it. They are sustained in this work by a flow of feeling that comes from removing uncertainty and replacing it with things to do. Advice does not enter into this as actively as we would like to think. It is more of an accoutrement, something that you expect to find in a decision situation and which sets it apart from work-a-day efforts. Vendors know this very well and carefully form the moment in which the executive will be encouraged to ‘seize the moment’ and buy. When an EMR acquisition comes to be seen as more fraught with difficulty than with promise, taking advice is a way for the decider to be quit of it. At this point in time it is useful to remind yourself that nothing about this is half so hard as learning to type. The main thing is that people are feeling put upon. The worst thing to do is just forge ahead with everyone already somewhat irked at what has gone on. They also don’t want to be put in a room with everyone else and be talked to. To suspend things entirely is also a poor choice – a virtual death sentence. Find the most troubling problem that you can do something about right away that leaves everyone alone and take care of it. Then, once it is clear the problem has been addressed, find the next problem that can be addressed and solve that too. With some credibility in the process restored, you can take a small step back and see which is the right course.
Buy in is obviously the most important factor, be the transition gradual or immediate.
I guess the first thing a practice should understand is whether they actually need the EMR or not. Sure, Govt. wants you to use it, but let’s put that aside for a minute.
Before buying an EMR, take a look around your practice. See how things are being done (workflow as John said), see who and how many people are doing a particular task, see IF using an automated system can help with those tasks or at least with some aspects of the tasks. For example, take a look at your scheduling operations. Do a survey to see what the average patient time is (and the reasons for the wait), try to find out how many patients cancel their appointments, find out how many patients try to schedule an appointment on a particular date but have to wait for another week or so. How many front-desk do you have working on scheduling? Do they call and confirm appointments a day or so before the patient is due? Do they even know who they are supposed to call? Do they know how many patients cancelled? Can they easily find out this information? Will a computer software help you and your staff with your scheduling operations? Is the kind of help you are looking for only available in a practice management software? Can you use a cheaper alternative to start with e.g. a free Scheduling software and later transition to something more elaborate? Will the system you pick transfer data to another system when you decide to move on? Is that data even necessary for future operations?
This is a brief example of just one function. There are so many more questions you (preferably the person responsible for the task) need to ask for every function in your practice before you decide to switch. Try to weigh the benefits you will get from a computer software against your current methods. Can you expect significant gains? Can these gains outweigh the costs? etc. etc.
Once again, never rush in. Don’t force stakeholder to agree to an EMR or PMS. See what alternatives you can use. See if you can implement the system piecewise.
But whatever you do, take your time to make your decision first and then go out and evaluate vendors and free alternatives.
Dr. Robert,
This is an interesting recommendation. I’ve talked about a phased in approach for a while. However, the reason I find it most interesting is because I’ve been mulling over technologies like a Fax Server that could be implemented now and start receiving the benefits of technology regardless of the EMR they choose.
The recommendation to document workflow is critical. It is a standard practice for “World Class” IT projects, but unfortunately most organizations (Medical and Non-Medical) do not take this step.
As you say, even if you delay an EMR project it is a great way to streamline the information chain of your organization and increase profits for your group.
Thanks for your insight…
I think it is very critical to get an EMR system which matches the current workflow of the clinic. Make sure to get a trial period into the software to run some real life scenarios.
I have seen that doctors purchase the EMR software based on features available & with loads of customization to be done ..but when the system is actually implemented it requires the practice to chagne its workflow , which is not possible.
Also, in my view another important factor is to have a Project Plan in place..incorporating the vendors as well as the practitioners needs, requirements, availability so on. Lack of planning & communication results in poor implementation, missed training sessions, inadequate customization & setup.