With the government’s electronic health record (EHR) incentive payment program gearing up in 2011, it’s hard to avoid the current buzz about EHRs. Whether you are motivated by the thousands of dollars the government is offering to get an EHR and use it, or you just recognize the benefits of automation, there are several steps to implementing an EHR. Here is some advice gleaned from the experiences of medical practices that have successfully implemented this new technology that may help you along the way.
Six steps to successful implementation
Define what you want. While the term EHR includes an array of products, the functionality of each system varies significantly. Don’t skip the important step of establishing expectations for what your practice wants and needs from an EHR system. For example, if participation in the government’s EHR incentive payment program is on your agenda, narrow your choices to systems certified for the program. Then, consider the features you want – a customized template; a fully integrated billing, registration and scheduling system; and a management dashboard, for example. Make a list of the features and delineate your “must-have” from your “nice-to-have” functions. Use this list to develop a request for proposal (RFP), and distribute it to vendors.
Narrow your choices. After you send the RFP, it’s time to get ready for the decision-making process. Your goal is to use responses to your RFP, as well as your own research, to narrow the systems to five or fewer finalists. To guide this process, form a selection team. A physician – or physicians – must be involved, but don’t leave out the opinions of key stakeholders such as your leading financial manager, nurse, medical assistant, lab/imaging technician, receptionist and/or business office staff. Choose individuals who represent the various areas of the practice so they can gather input from all levels and corners of the organization. Develop a written evaluation that the evaluation team can use to consistently review each system. Next, define a subgroup of stakeholders who will be the decision makers. This subgroup can use the team’s written evaluations as a guide to select the system and, perhaps, a runner up.
Confirm financing. While no system is perfect, it pays to purchase the one that best meets your needs – and your budget. In addition to system functionality, consider the customer service, training options and financial position of the vendor. You want this relationship to be a long-term marriage, not a short-term affair. In conjunction with the decision-making process, you’ll need to proactively consider financing options, which may include taking out a bank loan for the system and, perhaps, hardware required to run it. Don’t underestimate the additional costs of training, space, related infrastructure and technical support. You and your staff will need all of those items to get the system up and running, as well as to maintain it over time. Make sure you understand your practice’s tolerance for debt.
Get ready. An EHR implementation may require changes in workflow. Get everyone excited about the implementation by discussing the benefits of each new function the system will bring. Receptionists will love the newly streamlined patient arrival process that no longer requires walking each patient chart to the rack; triage nurses will appreciate having each patient call documented, as well as the elimination of delays in pulling charts. Consider carefully all aspects of the workflow. You’ll gain the greatest benefit from your EHR by planning what you want the flow to be post implementation – instead of trying to duplicate the flow you had with the paper system. If you anticipate participating in the government’s EHR incentive program, consider each criteria for meaningful use so that you can weave these criteria into your clinical and administrative workflow. Develop a “what the EHR means to me” for each staff member. Seeing those changes in print will help them recognize the impact of the new system on their role (and ensure that they understand and follow the new workflow patterns that you are counting on them to help execute). Combining this communication with details about the system’s roll-out will help establish expectations and reduce fears about the implementation process.
Train, train and train some more. Train a core group of “super-users” well in advance of training the full staff. They will be the leaders and troubleshooters for providers and staff. As these super-users are trained, seek their feedback so you will know how to design training and support for the rest of the staff. Formal training from the vendor will almost certainly be needed for all staff, so budget for it. Your super-users can then lend a hand and advice as staff practice with the system in the days leading up to the go-live date. Develop a physician super-user who can lead the training of other physicians and providers before the go-live date.
Implement. Choose a go-live date and expect the implementation to consume, at minimum, several weeks. Make sure each practice site has at least one super-user available at all times during the implementation. Establish patients’ expectations by developing signage and communicating verbally with them during the implementation. In signage and other communications to patients, focus on the EHR’s benefits – improved efficiency and better access. Avoid dwelling on the possibilities of service delays. If applicable, discuss the new communication tools the EHR will allow you to offer, such as an online patient portal for test results notification, appointment confirmations and prescription renewals.
Planning an EHR implementation requires hard work, but your time and effort will pay off in a successful installation of not only a new system, but a whole new – and better – way of working.
Sage can help
We understand Electronic Health Records and with thousands of completed implementations, we know how to help you make yours successful. Complete our Request Information form to find out how we can help your practice transition to Electronic Health Records.
