EHR Implementation

By: John Tech

Electronic Health Records (EHR) failure rates have been documented as being as high as 50% in the U.S. Some of this is due to choosing the wrong electronic health records software. Why has the other 50% been successful?

1. The right product. The first and foremost reason for success vs. failure is the choice of product. If you choose a lemon, don’t count on lemonade, at least with unrealistic expectations. If your doctor has been dictating his chart notes for 30 years, and a transcriptionist then translates that into the medical record, how is a mouse or keyboard intensive charting system going to work? If you already use Microsoft Word® to type your medical record, will a system with 1,000 pop-up questions really work to build your note? Change is hard, but usually because of improper expectations. Don’t expect to dramatically alter what already works for you. Pick something that will allow you to change as little as possible, but still get your practice paperless.

2. The right expectations. If you believe that you will still see the same number of patients on EHR Live Day, as you did before EHR, you should get ready for disappointment. No matter the EHR, you must understand that the entire medical office must be trained on the EHR system. As with any new toy, software has a learning curve. Even the most simple EHR software can take a month or two to get really comfortable with all the bells and whistles. Plan on taking a short-term hit for long-term performance. The principle of “you get what out what you put into it” applies. Plan to dedicate yourself to the project; otherwise you are planning to fail.

3. The right timeline. Hopefully you’ve chosen an EHR company that has performed thousands of implementations, and they’ve given you an implementation project manager with some experience under their belt. If not, be prepared to make some therapy time. Your project manager should be able to help you put together a plan that takes everything into consideration. Vacations, sick days, emergencies, and other scheduling conflicts will occur, and sap valuable training time from staff and doctors. There should be a plan for that. EHR cannot succeed without “pre-data”. That is information already in the system, so when you see Betty, her chart is already built. The timeline should account for that. Ask a ton of questions when your project is started, and make sure you have a comfort level. Hoping that they will do things right is not the way to succeed.

4. The right person. In addition to the EHR company’s trainer or project manager, you must have the right person on your side. Failure to identify your project lead will ensure you join the bad 50%. You shouldn’t have an IT guy or consultant assigned as the one who leads the project. Someone from your practice needs to be your champion. They should have some exposure to computers, and should not be afraid of change. The right person is critical to the job. They will become your internal trainer, and will be the expert when the EHR trainer leaves your practice.

5. The right staff attitude. Some practices leave a 900 lb. gorilla in the room when they adopt an electronic health records system. This won’t work. If you have transcriptionists that are going to be terminated upon adoption, make sure to take care of it before Live Day. Usually, however, EHR software does not immediately cost anyone’s jobs. Usually, through attrition or shifting job responsibilities, all clinic staff is retained. That doesn’t mean that fear won’t run rampant. Be clear with the staff and make sure that potential subconscious sabotage does not happen. Anyone afraid for their job will likely become a bad apple and poison friends and co-workers and their attitude towards the project. Have a staff meeting and have an open and frank conversation before the project begins. Make sure everyone understands their role in the change and make sure all gorillas are exposed.

6. The right timing. Ultimately, the decision to adopt an EHR comes down to timing. If you are a cash-strapped practice with no credit lines available, investing in a long-term solution may make for a short term failure. If your goal is to just go paperless to reduce costs, why buy an expensive EHR when a Medical Document Management (scans paper charts to digital records) will suffice? If you are about to move to a new building, can you plan for a paperless office without having tried it in the old office? Why buy on January 1st, when tax (and possibly vendor) incentives are available on December 31st? Timing is critical to success.

Plan to succeed. If you fail to plan, you plan to fail. This is true in sports and in EHR adoption. Do your research and make sure you have the right plan.

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For free information about health information technology, I recommend this electronic medical records site. Dr. John Tech www.chartlogic.com

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