Guest post by John Squire, president and COO, Amazing Charts.
According to the 2014 Exclusive EHR Study conducted by the MPI Group and Medical Economics, 70 percent of clinicians said their EHR investment has not been worth the effort, resources and costs. Widespread dissatisfaction with electronic records systems is casting an unfortunate shadow over the great potential they hold for making today’s medical practices more efficient and for improving healthcare delivery. However, practices can help avoid future disappointment with their EHR decision and save time and resources by understanding how to avoid common implementation pitfalls.
1. Choosing the wrong EHR
The intuitiveness and ease of use of your EHR will affect every area of your practice. If you don’t consider yourself to be technologically savvy, finding an intuitive solution should be at the top of your list. (After all, presumably you’re a clinician, not an IT expert.) Was a clinician was involved with the development of the EHR system? If a clinician wasn’t involved, chances are your idea of “usable” won’t line up with that of the vendor’s.
Another aspect to consider is cost, which can vary across a wide spectrum from free to several thousand dollars a month. Decide on the maximum price that you are willing to pay. This will reduce the list of vendors for consideration. Oh by the way, beware of the word “free.” Your biggest hidden cost is not the dollars spent on software, but the hours of lost productivity from a system that impedes you with banner ads and other annoying distractions.
To be certain that the EHR you choose is the right one for your practice, do everything in your power to expose yourself to the software prior to purchasing. It is worth asking the vendor whether they offer free trials. If not, consider watching video tutorials, attending webinars and shadowing another clinician using the EHR.
2. Underestimating the importance of an implementation plan
To ensure the smoothest transition possible, develop an implementation plan that will introduce you to your new EHR and also help you identify specific questions to ask the vendor. Your EHR vendor will likely have one to give you – just ask.
At a minimum, a useful implementation guide should tell you how to do the following:
- Create user profiles
- Set clinician schedules
- Set up test patients
- Set CPT codes/fee schedules
- Set up and activate e-prescribing
- Access your prescription writer
- Import patient demographics
- Manually enter patient information
- Connect to interfaces and more
3. Not enough training prior to go-live
A smooth transition is also dependent on the level of training for you and your staff prior to going live.
To ensure proper training, first you should designate some time — either set time aside time during work hours, or assign training to your staff as “homework.” Rest assured, the time invested for training will pay off once you implement the solution.
Next, ask each team member to create a list of their daily activities (and don’t forget to make one for yourself). Do not go live until each member of your team is able to complete each of their daily activities using the new system. Once everyone is comfortable using the EHR, use a “Dummy” patient to run through the new workflow.
If you’re transitioning from paper, keep in mind that going paperless should be a gradual process. Avoid uploading all patient information at once or asking a team member to start at “A” and work through the patient panel alphabetically. Instead, import the patient information a day prior to their next appointment.
4. Underestimating the importance of HIPAA Compliance
HIPAA, the “The Health Insurance Portability and Accountability Act of 1996,” was instituted partly in response to the rise of technology in medical practices to protect the privacy of patients’ personal health information (PHI). With the HITECH provision of the ARRA legislation in 2009, this protection was extended to electronic personal health information (ePHI). It’s critical you have policies and procedures in place to protect your patients’ ePHI in compliance with HIPAA guidelines– here’s why:
- To ensure you’re acting in the best interest of your patients
- To protect yourself during a potential meaningful use audit (regarding Core Measure 15 for Meaningful Use Stage 1 as required by the ARRA HITECH provision, which looks to protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities)
- To avoid the hefty fines (up to $1.5 million) that come along with a HIPAA violation
5. Falling behind on health IT regulations and government policies
Constantly changing policies can stress employees as deadlines approach; therefore, practices should create and use an action plan that it can apply to all universal policies. This will help keep the office organized, and once you’ve used it repeatedly you’ll follow the plan without even realizing it. For example, if your vendor announces that Windows XP will no longer be compliant, it is first important to get as much information as possible and ask specific questions, such as ‘If I haven’t finished switching operating systems (OS) by a certain date, can I still get support?’ Next, you must develop an action plan and execute accordingly. Action items should include consulting your IT professional to identify the best OS, and determining how to safely transfer data once the OS is purchased.
It is also helpful to identify a health IT policy lead who can stay on top of upcoming government policy changes by developing a menu of resources for your practice. Resources might include medical societies, EHR blogs, your EHR vendor bulletin board or emails from your vendor.
By systematically dealing with universal policy changes, you can avoid any last-minute problems and make the process of change go much more smoothly for your practice.
6. Getting stuck on how you used to do things
“Out with the old and in with the new.” It is human nature to resist change, and falling into old patterns is a tendency we all have at times. However, when implementing a new EHR, it’s important to use it for its advantages- set reminders, use decision support, educate patients through the secure portal. These are all advantages of an EHR that go beyond simply documenting visits. Some aspects may be annoying at first, but overall a thorough EHR implementation will make day-to-day workflow much easier.
Here are some not-so-obvious ways to make letting go of your old workflow easier:
- Reach out to fellow users in your area. Other users are a great resource for learning real-world tips and best practices.
- Attend user conferences. Not only can you connect with other users, but your EHR vendor will likely update you on its product roadmap and other new developments.
- Read updates and emails from your EHR vendor – These missives are usually full of good information for users, so don’t ignore them. You can stay on top of the last regulatory and industry news, get tips and best practices, and learn what’s coming in the future so you can be prepared.
Underestimating these pitfalls can make EHR implementation a nightmare, but taking steps to help avoid them will enable your practice to benefit from the moment it goes live. If you approach your EHR implementation with the same perseverance, attention to detail, and optimism that you bring to your patients, you’re well on your way toward a smooth and successful transition.