Healthcare has always been on the cutting edge of technology and medical advancement, yet private practices are sometimes resistant to changes when they believe they have a system that serves them well. Over the last several years, the adaptation of electronic medical records (EMR) and electronic health records (EHR) systems from hospitals and larger health care organizations have defined a new generation of systems that are designed to assist practices of every size and specialty with everything from patient health information, to orders and prescriptions, to billing and operational tasks.
The federal government has even passed a bill to encourage meaningful use of certified EMR systems and software including financial incentives for reaching implementation and meaningful use of these systems within a certain timeframe. The goal of encouraging the use of EMR or EHR software is to standardize how health information is used, allow easier access to patient information for practices and patients, provide a standardized form of billing to reduce errors and increase reimbursement, and to protect the integrity of the health information stored.
Implementing a certified EMR or EHR system is more than just jumping online or making a phone call. Implementation of electronic medical records is a process that requires research, planning and advice along the way.
Planning – Perhaps the most crucial step to implementation of EMR/EHR is the planning phase. Planning consists of several steps that must be evaluated in a particular order.
Practice Needs – First it is important to determine what the particular needs and goals are for an electronic health records system. What is the specialty? Does the system need to cater to outside referrals? Does the practice need e-prescribing? Does the practice need billing assistance or operational assistance? Does the system need to be certified? Once these questions along with others that pertain to the needs of the practice and use of the system are answered, you can move along to the next step of planning.
Choosing a System – Choosing a system can be a daunting task in itself. There are stand alone EMR and EHR systems that require hardware (servers, storage, backup drives) along with recovery systems to ensure the safety of patient records. There are also EMR software systems that are hosted remotely requiring less equipment in the office and offering backup and recovery services as part of, or in addition to, the master EHR system.
Cost Analysis – Once the type of electronic health records systems is identified, a cost analysis of the systems available should be made. Although there are financial incentives available for meaningful use of EMR, the incentive is a fixed reimbursement and may not cover the expenditure. Analyzing factors such as initial cost, training costs, staff hours including reduction in staff hours due to system task management capabilities, and hardware needed must be considered prior to making a final decision. It is important to recognize that the electronic medical records system must be certified to qualify for the meaningful use incentives detailed in Stage 2 of the Health Information Technology for Economic and Clinical Health Act (HITECH).
Testing and Streamlining – Once the perfect system to satisfy the needs of a practice is chosen, stage 2 begins. Testing and streamlining involves a two step approach.
The system chosen must be tailored to the needs of a practice. This step may be limited by the choice of EMR software or system. Some systems are ready out of the box and do not leave much room for personal tailoring. Other systems may require adjustments to serve the particular needs of a practice. Billing and procedure codes, as well as the specialties offered through the practice may need to be addressed to make the EHR more amenable to the operation of the practice.
The second step of testing requires mock or simulated use of the electronic health records system to work out bugs or issues that may hinder or prevent services from being rendered. As this step is taking place, the training aspect of implementation may already be under way.
Training and Education – A practice should never underestimate the necessity of proper training for implementation of EMR software or systems. Not only does training identify bugs in the system, but it also gives staff the knowledge and practice they need to hit the ground running without interruption in services to the patient and without interruption to billing and reimbursement that the practice relies so heavily upon.
Go-Live – The magic day finally arrives with a great deal of excitement and perhaps some apprehension. There will be some growing pains here, but as long as all the prior steps were approached systematically, and questions that arose were addressed and answered properly, the initial use of the system should go fairly smoothly. A representative of the EMR software or system provider should be on hand to address technical and procedural issues. This representative will be experienced on the system, experienced with initial implementation, and anticipating issues that might arise with prepared solutions.
Post Implementation Evaluation - The final step in successful implementation of an electronic medical record system is evaluation. This step will include a staff meeting along with vendor representatives to address concerns or issues that came up throughout the day, and more likely, first week of system operations. This is an opportunity to streamline new office operations that now work in conjunction with the EHR software or system. Staff can receive and offer each other feedback on ways to improve service and assure that the new system is serving all the needs that were discussed in part one of the planning phase.
Successful implementation of a certified electronic medical records system is a process that addresses the needs of the practice and fulfillment of those needs. Once the final step is completed, the practice will not only operate more smoothly and cohesively, but duplication of work and task management will make the workday more enjoyable and productive.