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Slow, steady EHR implementation plan better for doctors’ offices

A step-by-step approach is best for electronic health record implementation in doctors’ offices, a solo physician in family practice tells a federal work group.

Slow and steady should be the theme when doctors’ offices implement electronic health record (EHR) technology, industry professionals told a federal work group.

EHR systems hold a lot of value for doctors if they are integrated properly, according to Dr. Jennifer Brull, a solo physician in family practice. Brull and two other doctors in Plainville, Kan., collaborated two years ago on an EHR implementation plan.

“Our challenges were not software related, they were workflow related,” Brull said during a recent meeting of the federal Health Information Technology Standards Committee’s EHR implementation workgroup. The meeting addressed the impact that installing an EHR system and complying with meaningful use criteria will have on industry stakeholders. A separate discussion concluded that large health care systems should take a slow approach to their EHR implementation plan as well.

The doctors at Brull’s practice used a step-by-step approach; this allowed the staff to learn how to use the new system at their own pace without having a drop in patient volume, Brull said in her testimony. Within a year the office was paperless; it has now recouped the startup costs from the EHR implementation plan.

In addition, the practice’s revenue has increased since its EHR system was put in place, Brull said. It allows her to send reminder letters to patients, who might otherwise have skipped routine appointments. “You may not think reminder letters generate money, but they do,” she said.

The office is analyzing the changes it will have to make to its EHR system to comply with meaningful use criteria. Such changes will require updates to the system -- and purchasing those additional components is eating into the bottom line, Brull said

Besides using the EHR system in patient care, her office is working with the state quality improvement organization to analyze rates of vaccinations and cancer screenings, Brull said. The office also works remotely to conduct rounds at two nursing homes using laptops.

Helping doctors plug into health information exchanges

While her office likes incorporating health IT into its workflow, there are still barriers to complying fully with federal meaningful use criteria that are outside its control, Brull told the workgroup.

For example, doctors will be required to submit information to health information exchanges, but the state of Kansas doesn’t have an established HIE, Brull said. In addition, most small pharmacies in the rural area where she practices do not participate in an electronic prescribing network, so there is no way for a doctor’s office to send prescriptions electronically.

The final rule governing meaningful use should consider some of these obstacles, Brull suggested: “I am concerned that providers may be penalized due to circumstances beyond their control.”

Let us know what you think about the story; email Jean DerGurahian, News Writer.

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