Posted by: adelvecchio
EHR, EHR Adoption, EHR implementation, HL7
An ever-increasing number of physicians, hospitals, and clinics are implementing electronic health record systems. Providers are scrambling to choose the right software as deadlines for meaningful use approach.
To qualify for meaningful use incentives in 2013, providers who accept Medicare/Medicaid are required to attest and demonstrate meaningful use of an EHR system no later than March 31, 2014. In 2015, all incentives end and penalties will be handed out to those physicians who have not begun their initial three-month attestation period by September 30, 2014. Qualifying for incentives and avoiding penalties should be enough motivation to begin the EHR adoption process. In order to ensure a successful implementation, providers must first consider how an EHR will affect their practice.
William Stewart, M.D., a Tennessee-based otolaryngologist, has purchased three separate EHR programs and worked with several others. His experience provided him with valuable insights to offer to anyone considering EHR adoption. Below he shares the seven keys to successful EHR implementation.
1. Do your homework
According to Stewart, providers need to “do [their] homework,” and document every aspect of their daily workflow. This is especially important for a first time EHR adopter, as the most minor of details can affect implementation. The more you know at the start of the process, the less likely it is that you’ll have to repeat it.
2. Map out your workflow
According to Stewart, providers must “know what is important to [them]” when considering cost, features, integrations, etc. First time adopters might have some difficulty with this, so it’s helpful to cross-reference your workflow to determine your needs. A provider switching EHRs should seek input from a panel of stakeholders. This is especially important at the hospital level. Failing to seek input from nurses, IT staff, physicians, technicians, and other daily users will also likely end in replacing the EHR system.
3. Try before you buy
Stewart advises anyone shopping for an EHR to “seek out multiple EHR programs and ask for an online demo.” Online EHR reviews are available as a starting point, but with hundreds in the marketplace, narrowing down the options is valuable.
If possible, attend a health IT convention. EHR sellers often set up demo booths, and a savvy shopper can experiment with several different EHRs in an afternoon.
4. Look at more than price
“Don’t believe that you get what you pay for,” warns Stewart, “A higher price does not necessarily indicate higher quality.” Some of the worst-reviewed EHR software is also some of the most expensive. Alternately, some EHRs with a low initial cost are generic and need extensive custom programming. Without someone on staff to make the necessary changes, the customer must turn to the vendor or an outside consultant to perform the work at a significant hourly cost.
5. Check for templates
Stewart advises anyone purchasing an EHR to make sure it has customizable template functionality for progress notes and other input-heavy tasks. Without templates, physicians can drown in “tedious and encyclopedic…check-boxes and drop-down menus that increase the time required” for each office visit.
Once the templates are written and the provider becomes fluent in their use, an EHR “dramatically speeds up how fast you can see patients,” even compared paper charting, he said. In contrast, a poorly designed EHR programcan “decrease efficiency even after fluency,” so customization is essential in order to prevent duplicate data entry or other mistakes.
6. Don’t settle for less (than HL7)
Don’t consider an EHR that doesn’t follow Health Level Seven (HL7) protocol standards for messaging, interoperability, and data exchange. This is especially important if data ever needs to be transferred from one EHR to another.
Stewart called his last EHR migration “very painless” thanks to HL7. Without it, transferring data between EHRs can be both frustrating and time consuming. One EHR company even held patient records hostage when a hospital group switched to a rival system.
7. Keep a paper copy
EHR programs are supposed to help medicine become paperless, but the lack of interoperability between different programs at separate providers’ offices is holding this back. Unless physicians are working on the same program within the same building, information exchange is “all still done via paper,” says Stewart. Someday, EHR programs may allow a primary care physician to electronically forward charts, histories, and other documents along with a referral. Until such interoperability standards become commonplace, it’s wise to keep your fax machine.
Rushing to a decision about EHR software can result in an expensive mistake. Choosing the best EHR for your practice will take time, and require due diligence on features, limitations, and workflows. While this can be a tedious process, implementing the wrong EHR will ultimately cost more in the long run.