Implementation of EMR Paul Steven Collins MD FACS RPVI Assistant Clinical Professor of Surgery University of South Florida Bay Surgical Specialists St Petersburg, Fl
No Magic Formula However, Fail to Plan, Plan to Fail 30-50% of EMR practices will fail
Physician and Staff Champion Hardware and Software Setup Training Startup Plan Review of Templates and Patient Flow Post-Implementation Support What to expect
Physician Champion Interested Management Skills ability to convince colleagues to do the hard work necessary to implement the EMR Young or Old Background in computers not necessary Ability to adapt Plan,templates,workflow,paper
Staff Champion Particularly important when practice management is added along with EMR Has more time to discuss problems with vendor and also may aid in developing templates Liaison with non physician providers which are vital to the success of the EMR implementation Transition from Paper to EMR
Hardware and Software Setup Hardware from the vendor vs. market purchasing cheap may not be the best Wireless vs. a Hardwired office Will need additional software that will enable you to Interface with Hospitals,Labs,Multiple Offices, Home, Vascular Lab, Imaging Suites Tablets vs. PC s in the exam rooms security vs. ease of use durability of tablets Will need a trusted IT professional that is outside the vendor to work with your hardware and software
Training You can never have enough training May spend as much as 20-30% of the total EMR outlay on Training Learning curves are usually overestimated Must identify the best options for your partners and staff Training costs you in time and money Training will make or break EMR implementation When you feel as if you have the system figured out it is time to get more training
Startup Plan Identify Goals Agreement with physicians and staff as to the project implementation plan Go-Live in close Proximity to Training Vendor trainers available at startup Best to phase implementation can your afford to cut back your schedule to accommodate the extra time spent in learning EMR? What is the plan for the paper? slow vs. rapid introduction into the EMR process plan for scanning of old charts decision on new vs. old patient to make an EMR chart
Review of Templates and Patient Flow Post Go-Live Assessment is Paramount Assess staff and physician level of frustration, productivity, patient cycle times, workflows and learning assessment Make life easy for all involved Dragon Speak vs. Templates vs. scanned Transcribed Dragon Speak or Transcribed notes may not be able to be coded by the billing portion of your practice management system Essential to use Templates which are accurate, easy to use, and up to date
Post Implementation Support Continue to offer Training to staff and physicians May be available on-line,meetings,telephone,vendor trainers to return Adequate technical support for questions concerning templates, workflow,letters,new capabilities of the software, new needs of the practice, ability to network with other users of the same software
What to expect Frustration by Physicians and Staff Longer wait time for patients unless you cut down your schedule Longer hours spent by Physicians completing the visit Spending more money than you planned Possible increase in Staffing needs
What to Expect Increased Revenue from Upcoding Visits No lost records Availability of the record at any location where you can get internet access Decreased transcription costs Decrease in postage costs Patient satisfaction that you are a high tech practice Possible decrease in staffing
Money, Money, Money 2 years of practice management and EMR Practice Management $ 59,055 EMR 35,985 Claims Processing 658 E Prescribe 385 Additional Training 9,280 Extra Tablet 1,763 IT support 10,000 Monthly Support 35,000 Total to Date $151,106 Total Monthly Spending $1,700
Future Plans Ask a Nurse Prescription Renewal Forms Management Appointment scheduling Total 4,000 $ with increase in monthly spending of 300 $