Once the decision has been made by practice leaders to implement an electronic health record, many practice leaders start to worry about how to actually implement the EHR successfully. The primary concern for most practices during implementation is finding a way to avoid disturbing the physicians who are providing care and maintaining the practice’s administrative functions.
It would be easy to say that all implementations go smoothly from day one, but, in fact, there is typically no ‘day one.’ Implementing an EHR is, or should be, a carefully planned exercise in which practice leaders and staff may have to learn new ways to perform some of their tasks to maximize the technology’s efficiencies, which in turn, means increasing practice efficiency overall.
Implementing an EHR means change, and change can be challenging. Change is especially challenging when we are not prepared for it. But, by following a few simple tips, every practice leader can ensure that the implementation of their EHR will go smooth, not south.
1. Keep your eye on good patient care. For example, scanning can’t back up because providers need to trust that the electronic record has the information they need to make good medical decisions.
2. Listen to feedback—and use it. Don’t scrap the project if you get negative feedback, but use your management skills to change the process.
3. Evaluate your financial position. You can’t go into a project like an EHR purchase and implementation without a financial plan. Make sure you understand your practice’s tolerance for debt. Set up an internal payment schedule and determine your go-live date by how much time you’ll need to prepare financially. For many practices, the financial plan will have a longer time horizon than the training plan.
4. Look at overall benefits in a big picture, be realistic with the practices owners on implementation time and money, and focus on the end results and cost savings.
5. Go into the process because it is the next transition in your practice’s design: you’ll be able to get more complete information from several locations and, most importantly, you will be prepared for electronic quality measurement which may be the foundation of payment structures in the near future.
6. Make sure all physician leaders in your practice are on board. They may have reservations, but they must agree to commit to the change process.
7. Put the right people in project leadership positions. Base your decisions on basic knowledge, an interest in the project, a desire to learn and grow, a positive attitude toward change and the ability to communicate and work well with others.
8. Provide resources and time. Don’t starve your EHR implementation. Make sure your staff has the resources they need—training, hardware, space and support. Keep these commitments in mind as you create your financial plan.
9. Focus on small success first. A small success, for example, was the implementation of the e-prescribing module: the clinical advantages were apparent and it gave everyone a positive start to a major change in work flow.
10. Don’t overreact to problems. Practice leaders must eliminate ‘always’ and ‘never’ from their vocabulary.
11. Don’t implement other major changes at the same time as you implement an EHR. Clear the decks of other significant projects before the implementation.
12. Leaders must be visible. The practice’s leadership must be present and available during the first two weeks of EHR implementation.
13. Focus on training. Train a core group well in advance of staff. Make sure staff training is consistent and that staff leaders are available to others. Encourage and allow time for practicing on the system before the go-live date.
14. Have fun with the project. This is a new way of doing work.