Implementation of an Electronic Medical Records Rollout

Do you plan to implement EMR (electronic medical records) at your practice? If so, you're up for a large project. Something this big must stay on a timeline, or it may not ever reach the finish line. At our practice, we experienced several setbacks, including merging with partners, building construction, and hurricanes - all of these events pushed the launch date back a couple of years. A set date to go live helps get everyone on board and gets the team together to face what could be one of the more difficult changes that your employees will experience in their careers.

Select someone to be the project manager in charge of project implementation. It could be either someone from on staff (a top IT person or supervisor, for example), or you could hire on an outside consultant. Next you'll need a comprehensive plan that covers just who, what, how, where, and when your project will reach final rollout.

Before pulling the trigger on your EMR plans, be sure all of your financial assets are at the ready. It only takes a single absent or poorly-prepared component to cast well-laid plans down the path to ruin.

At a typical practice, physicians will range across the spectrum, from passive resistance to cautious optimism. Whoever is in charge of spearheading the project must decide when the doctors will roll-out, either in unison or staggered on different launch days.

Some physicians may be well-comfortable with allowing colleagues to test the waters; however, this could lead to more stress and work for the staff. For example, if one physician sees a patient and uses an electronic card, and then the same patient goes on a follow-up with another doctor using a paper chart, how will they reconcile the patient's chart?

If your practice has multiple locations, you may decide to implement electronic medical records at one office before moving on to the others. However, if your staff rotates between locations, your training plan must accommodate this. Also, if too much time passes in between office roll-outs, training may take a hit. Since we decided to start with new patients only, we chose to roll-out at all locations simultaneously, so clinics wouldn't be burdened by large disparities in staff training and skills.

As previously stated, a project of this size needs a firm commitment from the authority in your practice, along with buy-in at all levels in the organization. Just one negative voice from someone in a power position, and the entire project could be dragged down. If the practice is aware that a physician is working against the team, a managing partner may have to intervene. The administrators at the practice should not be bogged down with this task. Patients should be well-informed about the practice's determination to make headway into the future, so they'll forgive a little bit as clinics work out the kinks in the system.

If you don't exactly thrive on the idea of going electronic in a day, you may consider designing a system which sees only some patients on the EMR system. At our practice we decided to start with new patients only, to prevent our clinics from grinding to an abrupt halt. As patients return for follow-up visits, they continue to be seen using the electronic medical records system.

Is the hardware ready? Are your desktop computers set-up and configured correctly? Are the wireless tablets on-hand? Is software installed properly, and tested? Do you have a proper disaster recovery plan in practice?

Is your staff ready? Your schedule should include at least a month of intensive staff training before the go live date. You may need to create a staff rotation during the work day, or train people after hours and pay them overtime. The supervisor must determine if the staff is adequately trained to work with the EMR system in a real clinical setting; they will then need time to practice to keep their skills updated.

Are the structures ready? If you have been keeping up with this column, you understand that your facilities must be wired properly with network cable, and your wireless infrastructure must be tested and ready for action. Don't forget to make an accurate assessment of adequate bandwidth at each office location by adding up the total of all devices to be used.

By the way, do you want to learn more about implementing EMR in your own practice? Download my free report "Getting Through The EMR Maze."

Click here for the free EMR report.