Collecting EMR references has to be one of the underutilized methods of evaluating and selecting an EMR solution. If you cannot buy a laptop without asking around first, how would you want to get into a contract that spans over multiple years? Relying simply on what was promised is not a wise choice. User feedback can help physicians get a holistic view of the product along with the possibility of identifying various tips and tricks to better utilize such systems, particularly important for providers with no prior EMR usage experience.
Work can be split between staff members for better productivity and ideally physicians should participate with their administrative staff. This would help in establishing peer to peer level communication, allowing participants to gauge questions and responses better. While the practice may adopt multiple ways of communication, visiting the reference site in person or conversing over the phone may help in providing a more personalized outlook.
Another key is to not be limited to the contacts provided by the vendor. Physicians can find other practices by joining user communities or professional societies. Once you have established a reference sheet, the next step is preparing a questionnaire.
The most important questions to include in this questionnaire are:
- How long has the practice been using the EMR solution?
- How long did it take for the implementation to complete?
- How was the implementation experience?
- How long was the training process?
- Were the allocated training hours adequate?
- Did the application appear to be as easy as seen in the demonstration?
- How much of the annotation process is templates driven?
- Has the documentation process improved since implementation?
- How many patients were seen in a day before and after the implementation?
- How would they rate the quality of the exam note? Pre and Post implementation.
- Has the use of paper charts been completely eliminated?
- Did they consider or use scribes? If yes, what about the cost and quality?
- How would they rate their overall experience? And would they recommend the EMR to another practice?
Although this list is not by any mean exhaustive, but by asking the above questions most physicians will be able to gauge how suitable the EMR would be for their practice.
Although several EMR vendors provide implementation support along with initial training, it is always better for practices to plan out their implementation process themselves. An EMR significantly changes the practice workflow, staff responsibilities and work ethics; hence training the medical staff can be instrumental in determining the effectiveness of the implementation process.
Change management can be handled in various ways, however most practices rely on the tell and sell method by educating staff about the process change and the effect it may have on their individual responsibilities along with the reason behind the organization to adopt new methods; thereby ensuring goal congruence.
Another method is to appoint a change agent; usually office/practice managers taken on such responsibilities. The change agent spearheads the project by proactively promoting the need for change and its benefits along with managing staff concerns.
Staff education serves two purposes; not only does it helps in preparing and motivating the staff but allows them to actively participate and adopt the change as their own. Staff participation in the implementation process can allow for a more comprehensive and detailed approach, which reduces post implementation issues and frustration.
The other key aspect of shifting to electronic health records (EHR) is importing the existing data and patient information. Shifting from one EHR vendor to another is a much simpler process than going from a paper to paperless environment. Most EHR vendors provide the service of integrating data from legacy systems, hence reducing the post implementation workload.
Shifting to an EHR system can be very simple as well. Most practices start by recording all new patients and converting existing patient records for future visits. When an existing patient visits the practice, the staff can simply identify the paper chart and scan the document by linking to the patient profile, adding additional information through electronic charting when necessary. While the staff may experience more workload in the beginning, the scanning process reduces over time, gradually reducing to a few scarce instances.
Planning your EMR implementation process pays off. Hence, it is always better to be thoroughly prepared.