Andrea Morgan, AndreaKnowsEMR.com
As clinical environments become more imbued with technology, there is a constant need to evolve and grow. Changing capabilities and opportunities, the availability of information and the necessity to incorporate components in medical decision making that might not have been around 10 years ago necessitates the evolution of providers.
Most providers will agree that they want to care for patients, document appropriately, bill confidently and have a smooth transition from paper to electronic medical records. Having a plan in mind, such as the one outlined here, will go along way toward meeting the objectives listed above.
- Practice overview
- Role definition
- Current state workflow defined
- Future state workflow
- Design,build, validate
- User acceptance testing
- Build for production
- Go-live support
- Post go-live support can be provided by:
○ Newsletter/tips and tricks
- Refresher training
- On-going needs for training:
○ New hire training
○ Software updates
In an ongoing series, each of these steps will be discussed in turn. Let's take a look at Step 1, The Practice Overview.
Begin at the beginning - so obvious yet so often overlooked. With so much discussion about meaningful use, the stimulus incentive, reduced reimbursements – many providers want to focus on the end and how quickly they can get there. Taking some time to plan and WRITE down the process by which you will implement whatever EMR system you choose will save so much frustration and time later. Start with the end in mind and get answers to some fundamental questions. What do you hope to accomplish? What does a day in the life of your practice look like once the EMR is fully functional? If you don’t have a good reference point from which to start, go visit other practices that have already implemented. Ask your vendor for referrals then CONTACT those people.
Honestly assess which members of your staff may be less technologically inclined than others. The ability to use a smartphone or post videos to YouTube does not equal documenting in a patient's chart. It may be necessary to re-train or reduce staff. Very often roles change post-implementation because some tasks that were performed by staff now must be done by physicians. This can cause frustration so be mindful of it.
A few examples of tasks and roles that often change after an electronic medical record implementation:
- Letters to patients or referring providers – are these done by office staff or provider? Should they include the progress note?
- Refills - done by provider or nurse? is there a refill line? are refill protocols documented?
- Documenting patient history - is this done by the nurse/MA during rooming? how much time does that add to rooming process? Will you do chart abstraction? can patient update this info himself?
- Documenting phone calls to/from patients - how will information be communicated between office staff and providers? how many tries before creating documentation? Is phone call protocol documented?
Taking a look at the tasks and roles and identifying who does what will go a long way in getting your implementation started right. The practice overview is an integral part of the blueprint for a successful implementation.
Andrea Morgan is the founder and President of AndreaKnowsEMR.com As an EpicCare Ambulatory Certified technical trainer and consultant with over 15 years of pharmaceutical and EMR training experience, her areas of expertise include project management, curriculum development, and instructor led training as well as providing support to multiple medical specialities before, during and after EMR implementations.