Like it or not, EMRs are coming
Install your system right from the ‘get go’
By Donald G. Schoen

The case for electronic medical records (EMRs) has been debated for nearly two decades, yet doctors have not come to a clear-cut consensus about the benefits of implementing an EMR system.

Despite this lack of agreement, however, EMRs are here to stay. And because of the government’s continued focus on them, all physicians will need to implement an EMR system within the next five to 10 years.

Consequently, it’s important to make sure you do it right the first time.

Those who have successfully implemented an EMR system sing its praises, pointing to benefits such as admin-istrative streamlining and cost reduction, more accurate documentation, legible records, and better patient care.

On the other side, it is broadly estimated that the failure rate for EMR software is between 40 percent and 80 percent. The most cited pitfalls of EMRs include technical difficulties, cost, product compatibility, staff reluctance to learn the software, and lack of time.

Implementing an EMR system seems to present an even bigger hurdle for small specialty practices. Limited information technology (IT) resources and ever-shrinking budgets are additional factors affecting implementation.

So, is there a viable solution to choosing the right EMR program? And can the small practice doctor successfully implement an EMR system? The answer to both questions is yes — and the process is easier than you think.

• Pull all of the pieces together. As EMRs continue to gain acceptance in the medical industry, it is not surprising that doctors are bombarded by claims from a variety of EMR companies stating their product is the best.

The key is to find the right EMR system for your practice. Take a good look at your clinic and determine which aspects you are most interested in automating. Although the product itself is important, the implementation, training, service, and support received from the EMR vendor will have a significant long-term impact on your success.

Do your homework: Check out several vendors and use additional resources, such as online chat rooms, industry reports, references, and networking. Once you have done this, several EMR vendors will fall outside the realm of your consideration.

• Start with the end in mind. Author Stephen R. Covey’s advice to “start with the end in mind” is exactly what physicians need to do when they begin evaluating EMR systems.

Start by looking at your practice and come up with a profile that accurately depicts your needs, priorities, and constraints. Also, consider the total cost of ownership.

Look at the cost of the EMR system over a three- to five-year period. What are the upfront costs? What is the total cost of monthly fees to use (for example) a remote-based model?

• Work with what you have. Have you ever heard the phrase, “If it ain’t broke, don’t fix it”?

The phrase applies to implementing an EMR system. A fairly common misconception is for EMRs to be truly successful, you must have an integrated EMR system — your practice-management, EMR, and billing software all need to be from the same company.

In some cases this may be true. Or, if you do not currently have practice-management software, it would make sense to purchase an inte-grated version incorporating EMRs.

However, if your office is already running a practice-management system accepted by your staff and which performs successfully, why change it? Doing so could lead to loss of productivity due to retraining, rushed implementation, and a frustrated staff.

Adding EMRs to an existing practice-management system reduces these risks and can be easily achieved with EMR programs. With industry HL-7 standards and partnerships between healthcare IT vendors, interfacing between multiple programs has already been achieved.

• Develop a concise plan. One of the most common reasons for high failure rates among EMR implementations is lack of planning.

More often than not, physicians purchase an EMR program and assume it is easy to learn with little or no training. Realistically, feature-rich programs require in-depth and specific training. You cannot expect to take it out of the box and know how to use it.

Begin by working with your vendor and lay out a solid and concise implementation plan that includes an initial analysis of your practice, implementation guidance, and customized training.

Your vendor has the experience in implementing an EMR system and should play an instrumental role in devising the right plan. Use and rely on your vendor’s expertise and knowledge to ensure your success. If your EMR vendor of choice is not willing to help, you may want to look elsewhere.

• Don’t fear the change. Changing the current process within your office will undoubtedly be a challenge, but don’t be afraid of it.

EMRs can have a tremendous impact on the financial performance of a practice, as well as quality of care for your patients and quality of life for you. Big or small, however, don’t let fear stop you from seeing the successes provided by EMRs.

Automation is occurring now, and by accepting it, you will be advancing your practice and enhancing patient care. Successful implementation of an EMR system relies heavily on two parties — you and your EMR vendor. If both groups stay focused on EMR implementation, training, and support after the sale, you’ll be sure to get it right the first time.

Donald G. Schoen is president and CEO of MediNotes Corporation (www.medinotes.com), a best-of-breed EMR company based in West Des Moines, Iowa. He is also the current chairman of the HIMSS Electronic Health Record Vendors Association (EHRVA). He can be reached at dschoen@medinotes.com.