Selecting an Electronic Medical Records System: Choose Wisely

by Jason Clause Filed under: ARRA, Electronic Medical Records, Managed Services, Meaningful Use, Medical, Stimulus Program

Choosing the right Electronic Medical Records System (EMR) for a particular medical practice can feel like a daunting task. There are hundreds of options in the marketplace making it difficult for an organization to sift through all the available systems and then make a selection. A further complication is the process of selecting the perfect information technology for a specific medical practice. This complex process requires a real examination of the workflow for one’s particular office.

Software companies continually promote through marketing campaigns the idea that marketplace consumers simply need to purchase software, insert the disk, press OK and begin using the software. When a small business is attempting to apply technology to their workflow, the process can become significantly more complex and involved.

Industries such as accounting, legal and financial services typically staff a full-time employee to manage the implementation of their business software. Some private medical practices may have the resources for this approach but without this dedicated position it is risk as most physicians are not familiar with the technologies involved.

To help get your medical practice started, I have outlined a phased approach to evaluate, select, deploy, and continuously improve an implementation of an EMR. This is by no means an all-inclusive “how-to guide” but rather a guide to begin the process of EMR implementation.

 

Phase 1: Identify the Need

Identify the people in your organization that will be responsible for the success of the EMR implementation. In a smaller practice this is typically a doctor and the office manager.

Once the team has been selected, start to create the criteria that you will use to review and evaluate potential EMR solutions. This is an important step to take if the plan includes the evaluation of multiple software platforms. It is much easier to compare options with a predetermined set of criteria.

Investigate the U.S. Government Economic Stimulus Program to ensure that you are a qualifying practitioner. For information click here to view our FAQ.

Ask yourself this question. What are my expectations of EMR in streamlining the daily business routines in my office?  There are a whole host of features available as part of any qualifying EMR platform, i.e., e-prescription , faxing, referral letters just to list a few. It is important to first determine what features will most benefit your specific practice and what features fall into the “nice to have but not necessary” category. Completion of phase one will frame your requirements and establish a budget for this project. The number of “beneficial” features is directly proportionate to the cost and budget requirements.

 

Phase 2: Examine the Workflow 

Once you have an idea of the features you would like to apply to your medical practice the next step is to determine those features that will be used on a daily basis. The best way to accomplish this is to examine the current workflow in the office.

Take a close look at how you run the practice today in the paper world and ask these questions:

• What are the steps taken with each patient?
• What parts of your paper notes do you really like?
• What’s really challenging?
• What efficiencies or limitations do you have in your practice?
• What do you hope to accomplish with an EMR?
• Is time wasted looking for misfiled patient charts?
• Is phone tag with patients an ongoing occurrence because access to the information is not always available?
• Do lab reports take forever to get into a patient chart?
• Does printing appropriate patient education materials with the push of a button seem appealing?
• Do decision support tools matter?

Performing this exercise should help identify how to gain tangible benefits from an EMR system.  A sample list of criteria was created to help your office get started. Please email me to request a copy.

 

Phase 3: Solicit Proposals

Begin meeting with potential vendors now that you are armed with a list of selection criteria. It’s a good idea to exclude software options that are not CCHIT certified. EMR that meet the 2008 CCHIT certification standards already adhere to rigorous standards for interoperability and e-prescription. These and a host of other items will likely be requirements for your practice to qualify for federal stimulus funding.

Keep in mind when interviewing potential vendors that not all offers are the same. Some companies will offer software only, services only or some will offer both. It is always a good idea to have the same vendor that sells you the solution also be the one required to support your EMR. Proposals should include a description of how the vendor intends to move from paper to electronic data files and the one time cost to accomplish the change over. The proposal should also include an exact description of the vendor support program for your practice in the future and the ongoing costs to provide this service.

 

Phase 4: Implementation of EMR

Following the completion of vendor selection it is time to start the implementation of your electronic medical records system. The selected vendor should have outlined a phased approach to include:

• Purchasing, configuring and deploying the new hardware and software
• Examining your existing workflow and paper charts
• Applying lessons and insight from that examination to the business workflow of your EMR software
• Training everyone in your office to use the new software
• Repeated training if needed in your office to ensure competency with the new software
• Periodic follow up with everyone in the office to make sure they know how to use the software
• Follow up to make the necessary adjustments

Both the vendor and the practice need to adopt a “whatever it takes” attitude when it comes to making the transition work. The best vendor in the world will be unsuccessful if there is a lot of resistance from team members in the practice. Likewise, a rigid vendor that is more focused on the number of hours worked than actually getting the job done will likely contribute to a failed implementation.

 

Phase 5: Support is Critical

A well-designed and well-implemented EMR system is a great foundation, but it is not the end of the process. Software can be temperamental and sometimes users forget how to do something that they learned in training. EMR requires consistent practice for members who use the software to achieve the real benefits. Additionally, consistent use will likely be a key requirement to meeting the government’s “meaningful use” definition. That means that the software and the network that the system resides on must work reliably which is why it’s important to ensure that you’ve selected a vendor who has the ability and intention to support your practice long term. It’s important to understand when reviewing the vendor proposal, exactly how the company intends to support your medical staff users, your network and your data after the system has been deployed.

• Who will be called when there is a problem?
• What is the average turn-around time for support?
• How will systems and data be backed up for your office?
• What countermeasures and processes has the vendor put in place to ensure that your practice meets and stays current with the industry regulatory requirements i.e., HIPPA?

When making the important decision on the selection of a long lasting EMR system and vendor relationship, it is necessary and critical to take time. The failure rate for EMR implementations undertaken is 30% to 40%. An impulsive purchase of an EMR system is therefore ill advised. It is important to have everyone on-board at the practice with the decision, as it is vital to the success of this project. Using a selection process that’s methodical, critical and inquisitive will go a long way to help your practice succeed with electronic medical records.

Endsight works in partnership with gloStream and can help with the complexity of this process. Endsight provides an inclusive solution designed to help busy physicians like you through the change of migrating to electronic medical records. The process is called gloDNA and it stands for Detailed Needs Analysis.  Included is a slide show that provides more detail about this approach. Click here to learn more and to schedule a practice consultation.

Tags: CCHIT, economic stimulus, electronic medical record, Electronic Medical Records, EMR, emr system, gloStream, HIT, medical records system, onc, stimulus