In July 2008, the Medical Group Management Association released the results of a questionnaire that ranked members most pressing practice-management challenges. In this edition of Practice Makes Perfect, well tackle No. 5 on that list: Selecting and implementing a new electronic health-record system.
Selecting and implementing an EHR in a physician practice may seem as daunting to you as running your first marathon. But simply approach the process as youd approach trainingone step at a time, building on previous work.
First, establish a baseGather your team. Include someone from every area, from reception to medical records and transcription to nursing, the laboratory (or imaging), physicians and billing. The team needs to build a base of understanding on what the EHR can (and will) do to the practice. Visit other practices that use the technology, but dont fixate on particular products. Focus on new workflows that practices developed to gain the efficiencies the technology made feasible. Your team should evaluate your work flows and look for opportunities to eliminate operational inefficiencies. Is your goal to abandon paper charts? Do you want to acquire clinical data to participate in pay-for-performance initiatives?
Second, get the distance inSelect the EHR thats best for your organization. Call your affiliated hospital and ask if it can provide assistance with the technology. Bring three to four vendors to your office that have demonstrated the capability to meet your practices objectives. Have them give product demonstrations to the team and all interested staff. Check the vendors references. The team should be able to narrow the choice to two systems and make site visits to see how they function in a practice. One product should stand out by this point.
Third, the speed workDevelop a three-year EHR budget. The budget documents the monetary benefits (revenue increases from productivity improvements, cost savings, cost avoidance, etc.) and the cash outlays (hardware, software, conversion, initial and ongoing training, maintenance and any anticipated, short-term productivity decreases).
If the physician owners dont approve the budget, the process stops. This is where your running shoes meet the road. At this point, its a good idea to employ an attorney well-versed in software and technology contracts to assist with the contract negotiation.
Finally, the big eventimplementationYour EHR teams implementation plan outlines tasks, responsible parties and deadlines. Consider reducing patient volume during the implementation, since employees will have their hands full learning the new system. Many practices increase staffing levels during implementation, using temporary help or outsourcing chart conversions.
The implementation plans go live date may prove to be many go-live dates for phases of the system. Allow the dates to shift depending on how well the work flow adaptation occurs.
Post-race: the EHR recoveryJust as the post-marathon recovery allows for easy runs, after the EHR implementation, your practice will continue to adjust operations to adapt to the technology. As responsibilities shift based on what automation makes possible, staffing will need revision.
Fit and ready for the next challengeYouve automated your patient records. There are no more duplicate charts, every patient record is at your fingertips 24/7 wherever you are, and everything is up to date and easy to locate. Like your post-marathon fitness levels, if implemented correctly, the EHR can improve your financial fitness by increasing your groups revenue and lowering your administrative costs.
Rosemarie NelsonPrincipal consultantMGMA Health Care Consulting GroupEnglewood, Colo.