How to successfully plan and implement an EHR
Hiring outside help, purchasing quality hardware, and getting staff buy-in all important in this phase of adding technology
Buying quality hardware, hiring outside help, and getting buy-in from the practice staff members were three of six key ingredients that helped ease challenges associated with an electronic health record (EHR) system implementation, according to primary care physicians participating in the Medical Economics EHR Best Practices study.
In a recent Medical Economics survey, 30 of the physicians participating in the study were asked to identify key factors that helped them prepare for this implementation. Although the responses varied, the study participants offered this advice:
- Hire a scribe to help with data-gathering and the creation of templates.
- Identify one main resource person at your vendor to help guide you through the implementation process.
- Research and buy quality hardware that supports the EHR. “Cutting corners on hardware is penny wise and pound foolish. The stress, service calls, and cost of upgrades more than offsets the extra cost of buying good hardware,” says Dana Simpson, MD, of Life Center Family Medicine in Summerville, South Carolina.
- Get buy-in from your staff before implementing.
- Establish a timeline to complete online training each week before implementation.
- Set up weekly telephone conference calls with the vendor’s implementation manager to discuss progress, troubleshoot problems, and answer questions.
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During the implementation phase, a majority of the study participants contracted with professionals outside of the practice to help during the implementation.According to the survey, 44% of the participants contracted with an information technology (IT) professional or an IT firm, 12% hired other outside assistance, and 8% paid for assistance from a regional extension center.
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More than 60% of the survey respondents report that the implementation negatively affected patient flow. And although the unanticipated costs now average $3,094 among study participants, 85% of the respondents say no out-of-pocket charges were billed by vendors.Training was cited by many of the study participants as being a crucial to implementation success, but survey respondents were split about whether their staffs were adequately trained for the EHR implementation. In contrast, nearly 63% of respondents said the doctor was adequately trained.
Only 54% of the respondents identified the practice as having a “super-user.” About 46% of the study’s respondents report that the system’s training modules did meet their expectations. (The other 54% of respondents said they did not.)
Study participants where asked whether they have been able to integrate some of the interfacing features of their systems. The results include:
Images (scanned documents)
Yes: 52% No: 48%
Laboratory findings
Yes: 35% No: 65%
Billing
Yes: 40% No: 60%
Scheduling
Yes: 68% No: 32%
Hospital interface
Yes: 0% No: 32%
E-prescribing
Yes: 73% No: 27%
Health information exchange
Yes: 8% No: 92%
Compliance with the Health Insurance
Portability and Accountability Act
Yes: 68% No: 32%
Medical equipment
Yes: 8% No: 92%
When asked whether software vendors met their expectations, 42% of respondents said yes, but 39% remained undecided. Another 19% said vendors did not meet expectations.
Despite some of the negative views about implementation, the majority of the survey participants report making progress in the EHR implementation, according to the Medical Economics survey.
In the most recent survey, 82% were e-prescribing and 74% were able to maintain an active medication list. Just 19% were able to implement one clinical decision support rule, and 7% were able to exchange key clinical information among providers of care and patient-authorized entities electronically (see table).
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Participating vendors
ABEL Medical Software….. www.abelmedicalsoftware.com
Amazing Charts….. www.amazingcharts.com
Aprima…. www.aprima.com
athenahealth….. www.athenahealth.com
CureMD….. www.curemd.com
McKesson Physician Practice Group…. www.mckesson.com
MedNet Medical Solutions….. www.mednetmedical.com
Practice Fusion…. www.practicefusion.com
Vitera…. www.viterahealthcare.com
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