EMR: Plan the Adoption

My son is applying for college at this time. This is a huge decision, and huge decisions require careful thought. Still, if he ends up attending an institution with wonderful scholarships and great campus life but fails to apply himself and organize his time properly, the specific college he chose won’t matter.

You can apply that analogy to an EMR purchase. If you end up buying an EMR replete with powerful tools and great flexibility, but you fail to take the time to plan out and install it properly, the specific EMR you chose won’t matter.

Properly implementing your EMR is the most important step in the process of going paperless. The product itself is secondary to its implementation. In fact, you’ll be better off with a well-implemented mediocre EMR than a willy-nilly installed superior one, which will cause a drop in income, productivity, and morale.

What’s in a plan?

The reason you’re going to an EMR in the first place is to fix problems in your office. Therefore, the single most important part of the implementation plan is the answer to this question: What needs to be fixed?

Here are some examples:

• Lab results, X-rays, and consult notes are not readily available for doctors while seeing patients.
• Phone call work flow is difficult and slow -- getting answers for patient questions takes too long.
• Diabetic patients are not coming in for visits.

For each problem, ask these specific questions:

• What is the cost of this problem in terms of time, money, and frustration?
• Who does this problem affect?
• How does installing an EMR fix the problem?
• What steps must be taken to apply EMR to the problem?
• Which staff members are involved in fixing the problem?

Next, prioritize the issues. I recommend starting with an easier problem. For example, getting lab results into the chart can be done automatically with most EMR products via an interface (most vendors have interfaces already built to communicate with the major national labs). X-rays and consult notes can be put into charts using a scanning solution (also a part of most EMR products). With interfaces and scanning, the EMR suddenly becomes very useful to physicians and nurses, as it’s a reliable place to find needed information -- without requiring any work on their part.

Charting office visits, on the other hand, is very complex. Move these from paper to computer with the utmost care, as not only will they temporarily disrupt the flow of office visits (and reduce revenue) but also frustrate skeptical users. Spend extra time planning how you’ll capture office visits on the computer.

Once again: ** The key to a successful EMR implementation is proper planning. ** Note the underline, stars, and bolding. That’s how strongly I feel about this phase. Nothing is more important.

Robert Lamberts, MD, is a primary care physician with Evans Medical Group in Evans, Ga. He is board certified in internal medicine and pediatrics, and specializes in the care of adults, pediatrics, diabetes, high blood pressure, asthma, preventative medicine, attention deficit disorder, and emotional/behavior disorders. Dr. Lamberts serves on multiple committees at several national organizations for the promotion of computerized health records, for which he is a recognized national speaker. He can be reached at rlamberts@EvansMedicalGroup.com.