EMR in 2008 - Part One: Prepare for EMR

It’s not just about the selection of the Electronic Medical Records (EMR) Software solutions; but rather, it’s about the conversion from paper to the EMR solution and the execution of a well planned EMR deployment. Yes, this is more than just scanning the paper (which is a challenging task in itself). It has more to do with the mapping of the patient data into the EMR. In simple terms: Scanning a document and then electronically taking this scanned image and placing it into the appropriate fields and correct category within the new “e-file”. This will ensure that the new e-file is loaded with the correct placement of each scan, i.e. current medication, labs, imaging reports/images, referring physician and hospital reports, etc. The old adage “failing to plan is planning to fail” could not be more applicable when implementing an EMR. This well known expression begs the question: Why have so many physician practices had bad experiences converting from paper charts to an EMR and why have many deployments failed so miserably? Answer: Level of expectation and ongoing communication between the practice, the EMR vendor and the IT company. On June 16, 1858, in Springfield, Illinois, while delivering his address to his
Republican Colleagues in the House of Representatives Abraham Lincoln said “A house divided against it self cannot stand”. This is true of a medical practice as well. If the communication begins to falter, so will the implementation. Ongoing, preplanned meetings should be scheduled and kept. This will allow the appropriate people to hear and understand what is happening at the practice level all of the way through the implementation. Reliance on the EMR vendor to implement and adhere to an implementation plan for all aspects of an EMR implementation is a false expectation for a practice to have. You may consider assigning this task to a staff member or hiring a part-time project manager for a 3 or 6 month contract assigned exclusively to the EMR implementation project. The cost of hiring a project manager like this, pales in comparison to the cost of a failed EMR implementation. If an EMR is being considered, research is obviously very important. However, if too many hours are spent in the viewing of EMR demonstrations, too much emphasis may be placed on the EMR product as features and benefits are compared. Researching and comparing the post sale support, ongoing updates and customer support should be researched to an even higher degree. Converting from paper to EMR is not simple. There are so many variables to consider. Everything from over-promised and under-delivered products, un-kept customization and product enhancement promises. The practice may have unrealistic expectations and may not realize the time commitment that needs to be invested to ensure this total EMR conversion is well orchestrated.

The physician practice must also think about their workflow and how much they are willing to change their working status quo. To date, there simply is no one solution that can satisfy the needs at all levels. Sacrifices will have to be made.