In June, 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, we'll tackle No. 4 on that list: selecting and implementing a new electronic health-record system.
Practice Makes Perfect: Avoid EHR waiting game
With the current tide of practices implementing or optimizing EHRs around the country, the market is saturated with information on the subject. Doing a Google search on “EHR Implementation” results in more than 530,000 hits, including countless blogs, articles, webinars and conference presentations. So is there any new advice on the topic? Believe it or not, the best advice for selecting and implementing an EHR system in your practice is to act now and avoid the waiting game.
The last chance for practices to earn the maximum amount in the meaningful-use incentive program is Oct. 1, 2012. As we approach the end of 2011, many practices that have not begun to implement their EHR system still hope to maximize the bonuses for their eligible professionals (EPs). Most still see the end of 2012 as very far away, but it's not. Properly implementing and selecting an EHR takes a significant amount of time and consideration.
The selection process itself can be daunting. Narrowing the list of vendors, going through product demonstrations and checking references can take from four to six months. To do it right, you'll need to motivate the appropriate administrative and clinical staff from the practice to attend all meetings—not an easy feat for most organizations. During your selection process, focus on nonfunctional variables and ask questions directly related to user experience. How easy is it to use the product? Is everything where you need it? Is the screen too busy?
Establishing the level of support the vendor can provide is also critical. Ask for the vendor's references and ask how quickly the vendor resolves problems.
Once you've selected an EHR system, you enter the contract negotiation period. While most contracts are written by the vendor's lawyers and designed to protect the company in every way possible, it's essential to allot the appropriate amount of time for your counsel to go through the contract with a fine-tooth comb. Be sure to dedicate adequate time to negotiations, as this gives you more opportunity to amend issues you identify in the contract.
Once you navigate this process, it's time to implement your EHR system. The increased number of EHR implementations driven by the federal incentive program will leave some vendors struggling to accommodate new client installations. Significant delays are common because vendors lack availability. Depending on the size of your practice, and assuming you don't experience any scheduling delays, the EHR implementation process could take five months or more.
It is then time to look at the first year's meaningful-use reporting period, which is 90 consecutive days. To achieve meaningful use requires staff to use the EHR in a consistent manner, which could mean considerable training and trial and error.
When you add up the time you'll need to select and implement an EHR system, you may wish you had started this project much earlier. However, it's not too late, and some things have been working in your favor while you waited. The meaningful-use program itself has brought the product functionalities into alignment. If the software has been certified for use in the incentive program, at a minimum, it should have the capability to allow your EPs to successfully achieve the bonus—though certification does not address usability or level of vendor support.
Many aspects of the healthcare environment remain uncertain, but wading through information about how to select and implement an EHR system is the first step for your practice. And remember, there's never a better day than today to start the process.
Derek KosiorekSenior consultantMedical Group Management AssociationEnglewood, Colo.
Send us a letter
Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.