Implementing an Electronic Medical Records (EMR) system is more critical and more complicated than most physician practices expect.
Implementing an Electronic Medical Records (EMR) system is more critical and more complicated than most physician practices expect. Four pitfalls in particular impede a successful implementation: unsatisfactory project management and control, lack of communication, incomplete goal specifications and underestimating project complexity. To avoid them, consider the following critical success factors:
1. Select the right internal leadership team. At the outset, create an internal EMR committee. Select those in your practice who are most likely to be champions of EMR. Ideal committee members embrace change, contribute enthusiastically and have the respect of their peers. Note that the EMR committee must be familiar with the ultimate goals and benefits to working in a physician practice with a fully functioning EMR system.
2. Communicate the "What's in it for me?" EMR systems will return greater benefits if everyone is motivated to make the system work because they see a personal benefit, not because they have no choice. Accomplish this by asking about some of the employees' more tedious tasks and explain how these may be eliminated with an EMR solution.
4. Create specific and measurable goals. Establish specific goals to maximize return on investment. For example, an implementation is more likely to be considered successful if goals such as "decreasing outside transcription costs by 50% within nine months" are met. Such goals are more measurable in comparison to "making the office more efficient."
5. Develop a strategy for entering existing data. Determine what portions of existing charts will be included in the EMR and how far back you will go. Most offices pre-load amounts of existing data before going live with their EMR system. In these cases, patient visits often can be handled without the need to pull paper charts from the beginning. When more information is pre-loaded, that information can be quickly used to increase efficiency.
6. Devote sufficient time to training. Training on the new EMR software should occur as part of a comprehensive plan, not just on a certain day for what the user thinks he or she wants to learn. Provide a short overview, give users the big picture and some details about the most-often used features, and then let them play with the new system. Keep in mind that the best EMR software packages offer high flexibility to individual offices and users. Don't forget to use "dry runs" with "pretend patients" to make the most of practice time.
7. Plan to create "power users." Many in your practice will find it helpful to call one or two people who are more fully trained to answer questions. The best EMR systems contain extensive help files and personal client support, but it is always a good idea to have one or more point-people in the office who are familiar with your internal processes and can respond immediately.
8. Create an ongoing plan for answering questions. Make sure you and your staff are comfortable with the software functions you will be using. Be sure that everyone knows how to get the quickest answers if they get stuck or have a question (see the previous item about power users). This will ensure that maximum attention will be paid to the most important job: delivering quality care to patients.
9. Leave time buffers throughout the day. The first day that the EMR system is live, leave everyone a safety buffer and schedule fewer patients. This will ensure that office workflow will continue uninterrupted. You also should schedule fewer patients during the pre-live period so everyone has time to train.
10. Plan to succeed and you will. In speaking to medical practices
that have implemented an EMR system, it is difficult to find one who would prefer to go back to the old way of doing things. Still, the ease of achieving the ultimate goal can vary depending on the planning that goes into the project, particularly to selecting a strong project management team, laying the groundwork for excellent communication and establishing clear, measurable goals and objectives.
The bottom line
The message is simple: Careful planning leads to successful execution. However, no software company can replace your willingness to devote sufficient time and consideration to implementing an EMR system. Switching to an EMR system is a significant change, and the complexities are easy to underestimate. Regardless of the vendor you choose, your practice is ultimately responsible for successful implementation.
Tyler H. Patterson is vice president of product marketing at Misys Healthcare Systems.