EMR Implementation Best Practices
EMR Implementation An EMR implementation is an exercise in Change-Management
Challenges to EMR Implementation Lack of buy-in from practice team, complex political environments and diverging opinions of goals/priorities Financial cost of new computers, network infrastructure, software procurement, training, support, maintenance, The fear of change/obsolescence Conversion of existing hard-copy records Perceived/temporary loss of productivity, and/or income while users become familiar with the new system Change fatigue associated with large projects
Why are we doing this? The mission: Provide high-quality, affordable healthcare to all those that need it Benefits of EMR: Quality-of-Care Benefits Cost-of-Care Benefits Communication Benefits Analysis Benefits
What makes it all worthwhile Just do it! You will never look back. A provider satisfaction survey 5 years post-implementation shows: 90+% would not return to paper it takes 1 year for users to be comfortable with the system.
The Best Practices It s possible to identify Best Practices in each phase, each activity, of the Implementation Process
#1: Identify an EMR Champion The Champion: Someone who understands The importance/relevance of the EMR project and it s goals The system The users, their needs and the environment The processes The Champion should be Able to see the big picture Willing to lead/support process changes IT-friendly All users are not equal Adopters Adopters Viewers??? Innovators
#1: Identify an EMR Champion (contd.) That champion I was talking about? Not only do you have to spend extra time with the other users but before you start the program there s a lot of setup that needs to be done health care maintenance reminders and lab tables massaging existing templates for your practice and creating new templates I remember being here late in the evening, almost every day working another hour or two on the computer
#2: Get Physician Commitment to use the EMR Willingness to change Typing instead of writing or dictations Time Commitment Learning how to use the EMR effectively Customizing workflows/forms to suit themselves Creation of documentation shortcuts, favorites
#2: Get Physician Commitment (contd.) The EMR disrupts your workflow initially. There is a learning curve to actually use it in the room with a patient, or to document using a combination of handwriting, notes, and data-entry or dictation. It takes a couple of months to really become a competent user. Classes or tutorials are better than doing nothing, but once you have done them, you feel at the barebones level of being able to use the EMR.
#3: Maximize Electronic Data Exchange Critical to saving time and reduction of errors hence to reducing costs Integration of various systems to ensure that appropriate data flows between Machines with the Lab Lab and the EMR EMR and Billing EMR and Inventory/Stock People Consults, Requisitions,
#4: Arrange Comprehensive Support Helpdesks and Support Process Technical Issues: Hardware, Software, Networks Process Issues Forgot password Which menu item should I select? How do I handle a situation like? How do I undo?
#5: Train, Train, Train, and then Train again Hiring and Attrition Features and Functions Disuse Misuse/Abuse Fantastic source of feedback and basis for an improvement cycle
#6: Motivate Care providers to use the system Rewarding Care Providers that electronically document create (or help create) savings generate new business The carrot Respect Respect Speaking Engagements, Case Studies Link to salaries/payments and The Stick
#7: Set Goals Measure Publish Evolve Simple numbers to stats Number of logins/incidents Length of Stay, Cost of Stay %age of incidents where the primary diagnosis was confirmed by the lab tests Find the success stories and publish them Use analysis to continue to improve your EMR system configuration
Summary 1. Identify one (or more) EMR Champion 2. Get Physician Commitment to use the EMR effectively 3. Maximize Electronic Data Exchange 4. Arrange Comprehensive Support 5. Train, Train, Train and then Train some more 6. Motivate Care Providers to use the system 7. Set goals Measure Publish Evolve
EMR Implementation Best Practices