10 recommendations for successful EHR implementation

Adoption of electronic health records (EHRs) by physicians and healthcare providers has been relatively slow despite the perceived benefits of better office efficiency, improved patient care, lower costs and potential financial rewards.

If you haven't yet moved forward with plans for EHR implementation, take a step back and consider what you should be able to gain through use of this technology. Here are 10 recommendations to lead you through the thought process.

1. Leadership plays a major role in successful EHR implementation.  The physician or office manager needs to be a leader and offer support to others during the implementation process. If a physician fails to embrace the new technology, fully integrating an EHR system into the office will be a more difficult task. Leadership counts and it starts at the top.

2. Identify a project manager to spearhead the implementation process. Ideally, you should designate the project manager before you select a vendor and sign a contract. The project manager will gather information on vendors and lead the selection process. If the clinic is large enough, the project manager may put together a team to help gather information and select a vendor.  Team members may represent different departments such as accounting, nursing, HR and management.

3. Create a team atmosphere.  Everyone in your practice will play some role in the implementation and use of your new EHR system.  Though some roles are more important than others, everyone needs to understand that they are valuable to the team effort. Their value and their roles should be clearly defined and emphasized.

4. Raise awareness and enthusiasm for the implementation process. Schedule meetings to discuss the importance of the project and the benefits that an EHR offers. During these meetings, realistic goals should be set for successfully implementing the system. At the same time, it is important to remember that everyone -- from the billing manager to the physician -- has other work to complete. Trying to force early and unrealistic implementation and use dates will undoubtedly slow down the process and discourage people from learning the system.

5.  Register to participate in the Medicare EHR Incentive Program.  Registration is fairly simple and doesn’t mean that you are committed to lot of additional work, but you can avoid the risk of Medicare payment reductions after 2014 and can be eligible for up to $44,000 in incentive payments over the next five years.

6. Have a plan before starting the implementation process.  The following tasks should be recognized and planned before you begin to implement an EHR system:

  • Assess workflow at your practice and identify which processes will change.
  • Identify what is "good to have" versus what you "need to have" in terms of EHR capabilities.
  • Focus on clinic efficiency rather than too many feature requests.
  • Avoid creating extensive data entry-focused templates for physicians.
  • Select hardware after talking to your EHR vendor.
  • Create a plan of action in case of emergency.
  • Request workflow customization from your EHR vendor upfront.
  • Identify the labs with which you want to interface with your EHR.
  • Determine how will you scan and import all your old charts.

7. Your office manager can help staff determine what data needs to be entered and what can be eliminated, keeping meaningful use guideline in mind. This process needs to go smoothly and quickly, and will depend on the physician’s opinion and the amount of time available for data entry.

8. Training needs to occur on a regular basis. Training should include basic skills, application functions and live instruction. Physicians need to be an integral part of the training as a representation of the importance of EHR implementation and to increase their own ability to utilize the system. This is critical part of EHR success; if your staff is not properly trained, then the EHR implementation becomes a painful process.

9. Utilize compatible hardware.  Assessing your current hardware and making appropriate changes will ensure that all hardware is up and running for training, implementation and use of the new EHR system.

10. Choose the right EHR company. Clinical staff must be able to focus on patient care and not on computer data entry. When identifying an EHR vendor, focus on how the EHR will help you keep up with technology as well as patient care.

Ash Mehta  is CEO of San Diego-based PatientClick, which offers a web-based EHR system designed for small to mid-sized clinics.