Tips for vetting an EHR vendor for daily practice

Take home

Here are several key steps that every practice should consider for successful implementation of an electronic health record vendor.

By Ronald J. Purnell, MBA, COE

The manner in which a new electronic health record (EHR) vendor is brought onboard depends largely on the practice’s culture.

However, here are several key elements that every practice should consider for successful implementation.

1. Enlist help of qualified staff

The first step in initiating the EHR system was enlisting the help of tech-savvy, positive, and enthusiastic staff members to help with implementation. For example, one of the staff members came from a primary-care physician’s practice where she had been utilizing an EHR system for some time.

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She was excited about transitioning to an EHR system, and reassured staff that the process would increase efficiency and would be appreciated in the long run. She was an asset to the core team. Anyone who loves the Internet and is considered to be a computer “geek” should be asked to help.

On the contrary, a staff member who is anxious about computers or who has a negative attitude about EHR in general might be better off being training last, after others have implemented the process.

Staff members were designated from each area of the practice: medical records, billing, front desk, technicians, and physicians. A solid team allowed the process to run smoothly.

Core staff members were responsible for reviewing how information flowed through their area and which paper forms they would need to find an electronic version of, or workaround. For instance, receptionists have several forms they can create electronically: telephone triage, in-office triage, medication triage, contact lens triage, physician follow-up, physician note, and medical records. (Figure 1)

Additionally, though support staff at the vendor (ManagementPlus) was relied on for guidance, most of the customization was performed internally with the help of two computer science college students looking for employment-related experience.

2. Seek feedback from peers

Extensive communication with administrators across the country was made as well as networking with other eye-care practices that implemented EHR in a short period using stock templates with little or no customization. Although there seems to be no formula for what works and what causes a nightmare, one common thread is a full understanding of what each system is capable of and what limitations each may have.

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Choosing an EHR system is like buying a car. For instance, my wife loves her small SUV because it offers good gas mileage, winter drivability, and easy access. Many of our doctors drive full-size, nine-passenger SUVs. My wife’s car will never tow four snowmobiles and seven passengers to camp in the winter, but it meets her needs.

There is absolutely no substitute for spending the time and money to visit practices similar in size and make up to see what works for them. Many vendors also have users meetings that are a great way to get a full look at a system and speak with others about their experiences.

3. Designate resources

Many practices that are implementing an EHR system simply do not plan to spend the proper amount of time and money on the process. It takes more effort to lay the groundwork for implementation than it actually does to implement the system.

Practices should consider the time and expense that will be spent on training, customization, and IT support. The team will need dedicated time for testing and training outside of normal clinic operations. Many practices try various tablets, laptops, personal computers, and touchscreen computers to discern which works best for them.

4. Phase in the EHR

The decision was made to phase in the EHR system gently. Implementation began in the smallest satellite office, on the slowest day, and with the last new patient of the day. By starting with new patients there are no past records in the system to review and the focus can remain on the current visit.

Additionally, by starting with the last patient, if the process of inputting patient data happens to take an hour then it will not create a ripple effect and cause other patients’ visits to be delayed. In the worst-case scenario, the staff just leaves the office slightly later than normal.

Once staff members become comfortable using the system with the last new patient of the day, the process moved to the last established patient and then to the last couple of patients of the day. The number of patients was increased slowly, until EHR was used for all patients. Very quickly, staff members began to build up steam-they understood how the software worked and input data faster than with paper records.

Conclusion

Above all, it is imperative for staff members to have realistic expectations for EHR implementation. Mastering an entirely new computer system-similar to studying a new language or learning how to drive a car-it is not something that can be done overnight. Instead, it requires patience and thoughtful planning.

Ronald J. Purnell, MBA, COE, is the administrator and compliance officer at Eye Care of Maine, Waterville, ME. Purnell has no financial interest in the products or companies mentioned. Readers may contact him at 207/873-2731 or rpurnell@maine2020.com.