Why implement an emr system

The key to implementing an EMR and securing these meaningful use benefits for a small family practice or large medical facility is to have a solid implementation plan in place.

This plan should begin with the selection of a solid service provider, and conclude with ongoing post EMR implementation management and system refinements. Electronic medical records and patient safety is another important area to consider. An experienced EMR consultant will advise your organization on an electronic medical records implementation schedule that helps you most efficiently in the transition process. The EMR project manager and his team should frequently remind the medical and office staff of the ultimate benefits of implementing an EMR system in terms of increased work efficiency and lessened work stress.

Complete an EMR Implementation Workflow Analysis Every job and task should be analyzed and ideas formulated for enhanced efficiency within the new system. Every place where electronic records can feasibly take the place of paper should be noted. Do not disregard or avoid professional medical advice due to content published within Cureus. The authors have declared that no competing interests exist.

National Center for Biotechnology Information , U. Journal List Cureus v. Published online Sep Author information Article notes Copyright and License information Disclaimer. Corresponding author. Roboam R. Aguirre moc. Received Aug 26; Accepted Sep This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

This article has been cited by other articles in PMC. Abstract Implementing an electronic health record EHR can be a difficult task to take on and planning the process is of utmost importance to minimize errors. Keywords: electronic health record, medical record, ehr, emr, ehr implementation, electronic health record implementation, electronic medical record implementation, medical record implementation.

Introduction and background While searching the internet for literature related to the selection and implementing of electronic health record EHR systems, it was observed that several publications were addressing a specific aspect or a few aspects of the selection and implementation. Testing the EHR Testing the implemented EHR ensures that every system in place is put through its paces to ensure data tables and files are loading properly, data collected are processed and store correctly.

Testing scope and environment required In preparation for testing, the scope of the test will be defined as the testing for infrastructural readiness, application configuration readiness, and training readiness. Objectives for the test Developing testing objectives such as the ones listed herein will help ensure that the system is working properly and producing the correct results.

Testing strategy and test schedule The strategy to test the system includes a pre and post-go-live system testing, a patient communication guideline to include expected downtime, staff scheduling and required overtime or temporary staff, modification of appointments and scheduling, reporting processes for system and project evaluation, communication tools boards, etc.

Identified risks The risks associated with the testing and implementation of the new EHR system are those related to not achieving the objectives set for the EHR implementation.

Document all changes for reference. Screens appear as expected content and placement of fields, codes, drop down menus, and messages. No spelling errors or color changes. Readable icons. Appropriate representation of content can be printed if necessary for legal purposes. Entries that have been corrected and their corrections are both displayed accurately.

Fields edits e. Alerts and clinical decision support provides appropriate reminders and prompts. Use scripts to test various scenarios. Interfaces between applications move data correctly and completely.

Test both sending and receiving when interfaces are bi-directional. Connectivity with external organizations is accurate and complete as authorized e. System access is appropriate per assigned privileges. Test attempts to gain access when not authorized. Data are processed accurately, in graphs, tables, claims, client summaries, reports, etc. Data correctly populate registries, reporting warehouses, etc. Integrated Testing simulates live environment Ensure all system components that share data or depend on other components work together properly.

Ensure that workflows reflect actual new processes and workflows. Ensure that usage is defined in and follows policies and procedures. Reinforce training as applicable. Ensure that help desk, support personnel, and other aids function properly. Ensure that EHR works with all forms of human-computer interface devices and modalities being used e. Attempt to break the system by testing mission critical and high risk functions, such as situations requiring exception logic e.

Simulate an extremely high volume of activity on the system such as would exceed anticipated peak loads of system usage. Measure the time it takes to generate reports and data dumps, and the impact on system performance. Open in a separate window. Table 2 The advantages and challenges of each electronic health record EHR implementation approach: immediate and incremental.

Table 3 Strategies for immediate and incremental electronic health record EHR implementation. Frequent and open communication throughout the implementation process can go a long way toward overcoming resistance. Agency-wide acceptance of and support for your new system is an ongoing process. Consider the perceptions your staff may have and fears they may be experiencing:.

Patients—particularly older, less tech-savvy patients—may be concerned about how your new EMR system will impact their care. Make sure agency patients know about the upcoming EMR implementation.

They should be aware of what will be changing, when the changes will happen, and what the changes will mean to them. Planning and analysis should begin before the start of your EMR implementation. Know what you want from your new system, and decide how you will evaluate your progress. If you clearly delineate your goals and objectives ahead of time, and identify your metrics of success, then you will be better able to support and accomplish your goals throughout the implementation process.

It is beneficial to make as many decisions as possible before implementation kickoff. You and your vendor began the necessary information-gathering at your first meeting, with a joint consideration of agency timeframes and vendor-recommended schedules.

Through questionnaires and phone calls, documentation reviews and workflow analyses, the information-gathering by both vendor and agency should be comprehensive and continuous throughout the EMR implementation process. One of the first decisions that needs to be made is how your agency will launch the new EMR system. This should be decided long before kickoff, as the launch strategy will dictate necessary implementation procedures and timelines.

Big Bang : All agency patients, departments, and product lines ie, home health, hospice, private duty go Live with the EMR at the same time. With this approach, the learning curve for users is much shorter and it reduces the potential for confusion between old vs new system or paper vs EMR procedures. The downside: any procedural bugs or system issues are realized on a larger scale.

The big bang launch requires dedicated agency support and a commitment of resources during the implementation process and post-Live adjustment period. With this approach, the agency has the chance to work out any procedural bugs or system issues on a smaller scale; they have the opportunity to observe, analyze, and fine-tune best practices—one patient, department, or product line at a time. The downside: the learning curve for clinical and office users is gentler, but longer, and new users can lose energy and enthusiasm for the implementation process the longer it takes.

Your vendor will have recommendations for what works best for their system and how your agency should proceed. At Thornberry Ltd, we recommend a thoughtfully phased preparation and a combined roll-out approach: all departments and product lines go Live together, with each new admission or recert entered into the NDoc system exceptions to this approach are sometimes recommended in special or complex circumstances. By the end of 60 days, every agency patient is on NDoc.

In support of this combined approach, the Thornberry project manager oversees every phase of the implementation process, from pre-server installation through the first or second month-end closing. Remember that the right hardware can save your agency time and money up front and down the road. The implementation schedule should address hardware and software installation, agency workflow analysis, launch strategy, system configuration, data migration, training and support, and more.

Your vendor should also offer a phased timeline and a multi-disciplinary detailed task list for all affected agency staff that clearly outline and define implementation roles and expectations. What may seem inefficient or even undoable at first may actually be the most efficient and effective implementation strategy for your agency.

Your implementation plan, timeline, and task lists will be multi-faceted, interdepartmental, and carefully customized to your agency. The implementation timelines run concurrently among agency staff and departments, with many tasks starting at the pre-implementation phase and continuing throughout the entire process.

Following the timelines and task lists your vendor provides is critical to the success of your EMR implementation and roll-out. A strong, interdisciplinary agency Implementation Team is integral to the success of your EMR implementation. All Implementation Team members should be enthusiastic about the new EMR system and supportive of the necessary procedural changes and adjustments it will require.

Your first selection should be a project manager, who will oversee your implementation on the agency side, working closely with your vendor project manager to ensure a smooth transition to the new EMR. Your project manager will need dedicated time to help oversee and manage your EMR implementation. In addition to the project manager, your Implementation Team should include an IT information technology leader and a representative from each of the main clinical departments in your agency: RN, PT, OT, etc.

Thornberry Ltd recommends at least one mentor per every 10 staff members to be trained. All Team members will function as mentors and morale builders, mediators and messengers. Team members will monitor and analyze system usage and agency workflow, and will help to mitigate and manage the impact of the new EMR—from implementation through the first months post-Live. One of the first tasks your Team should undertake is an honest assessment of agency workflows and procedures, and it should begin prior to kickoff.

Take an honest look at staff and system capabilities, keeping your defined goals and objectives in mind. Some things to consider as you assess each task or step:. Even the smoothest implementation can run into rough spots, so you should build troubleshooting time into your schedule and make it an ongoing priority.

Identifying potential problem areas early can help to mitigate their effects and expedite their resolution. Make sure your risk mitigation plans consider:.

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