Monday, April 9, 2012

Successful EMR Implementations

I decided to skip the next obvious topic about choosing an EMR because, I think that topic has been exhausted everywhere. On the other hand, I can offer some practical advice on the best way to implement an EMR in a medical office.

The very first thing you must realize when you decide to move to an EMR is that your workflow will change. Don’t be deceived by any vendor who tells you otherwise. Still, that is not a recipe for disaster – it is one for improvement! You must be prepared to change the way you do things and you need to be ok with that. The change from a paper record to an EMR is a little like when we all began moving from typewriters to Microsoft Word. It was weird, right? It took a some adjustments, but soon you realized how much easier typing had become.

Once you are mentally prepared and understand that things must change (for the better) you are ready to go.  Having worked in healthcare for years both as a consultant and working with EMR, I have found that the best implementation practice is to have a staff cheerleader. The staff cheerleader needs to want the change and needs to drive the change. The staff cheerleader should also be what some people call the ‘super user’.

EMR vendors will either offer to do your implementation in person or virtually using web conferencing technology. Either way can be successful if you have a cheerleader/super user. That super user should be the first person trained directly by the EMR vendor and will not only drive the rest of the users to implement the EMR successfully  but also become the on-site ‘go to person’ for the rest of the staff. So, how do you find the right person to be the super user?

The super user must be a person who embraces change. This must be a person who is flexible and willing/capable of learning new things. A super user must be comfortable with technology. The best super users are those who are not afraid to play with a new software, even without or before formal training. Super users are by nature inquisitive and have a clear vision about how technology improves workflow.

Again, the super user is the cheerleader. This person has to be a leader who can encourage and motivate others to see the improvement ‘vision’. You can help the super user to be successful by giving that person clearly defined goals and authority. Without authority, the super user will not be able to drive change. This is not to indicate that the super user should become a dictator, but the super user needs to be able to set goals for the rest of the staff and offer positive reinforcement as needed.

Once you have identified the super user and the EMR vendor. Make sure that super user is an expert on using the software first – then he or she can train the rest of the staff. If you have a large practice, you may need multiple super users, even perhaps super users for specific segments (like billing, clinical, front desk, etc.) regardless having a super user(s) on staff is integral to a successful EMR implementation.

When the super user is ready, he/she should define incremental implementation goals. Don’t try to do everything at once. That will just overwhelm the staff (particularly those who are not comfortable with technology). Start slowly and add new things as staff becomes comfortable using the software. For example, your super user may choose to start by teaching the front desk to enter demographics and use the new software’s calendar. Once the staff is comfortable doing that, you can teach the staff how to verify eligibility electronically.  

Of course, this is just an example. In reality, some EMR software have these features intertwined so smoothly that you may choose to implement all those items simultaneously… but you get the idea… slow and steady wins the race! Your best bet is to ask your EMR vendor for help. The vendor knows the software and they have likely done hundreds of implementations just like yours. The vendor will be able to recommend how to break up the system in to incremental implementations.

Here, it is important for you to realize that this type of implementation will take longer than jumping in to it all at once. BUT, you will find that this is more successful. When you jump in too quickly, people get confused and make mistakes that WILL impact revenue and performance. If you take it slowly, implement in bite sized pieces over the course of 3-4 months, you will minimize (or even eliminate) any negative financial impact that could have resulted from the change in workflow.  


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