Guest blogger Robin Smith shares some essential tips for adopting and implementing an electronic health record in a small- or medium sized practice. Robin is the Business Manager for Nephrology Associates, P.C. in Birmingham, Alabama. If you have any questions for her, please leave them in the comments.
When you are implementing an electronic health record in a small- or medium-sized practice, organization and efficiency is key. I cannot put enough emphasis on planning prior to implementation. Here are some key things to consider:
- Identify a physician in the practice who will lead the project, taking ownership of physician communication and acting as the primary physician contact with your vendor. Choose a few staff members to be the “super users” that the other physicians and staff can rely on to answer day-to-day questions and get these “super users” extra training. If your staff and physicians cannot efficiently navigate the system, you are looking at an impending disaster.
- Evaluate your internet connectivity. I recommend at least a T-1 connection for a small office or T-3 for a large operation. A T-1 Internet line is a fast, multi-channel line that offers higher bandwidth and capacity than typical business-class cable (fiber optic line) or DSL alternatives. A T-3 line is equal to two T-1 lines and will handle much more internet traffic. If these internet connectivity options are not available in your area, your system may run slower than optimal to operate an efficient EHR. Using fiber optic cable through a television cable company or phone service could be an alternative if you do not have T-1 service in your area. The issue with that approach is the looming threat of the lines being down due to unforeseen circumstances.
- Begin the transition to a paperless office. If your physicians have been practicing for decades, you may be wondering what in the world will happen with all those charts! Before you implement an EHR, purchase software from an outside vendor and allow your EHR vendor to interface. It will be the best way to begin the process of changing over to a paperless environment. We chose this route and Acumen was able to interface with our vendor and place a link on each patient’s dashboard, enabling us to dispose of thousands of paper charts, do away with unnecessary storage cost and put every patient’s history at the physician’s fingertips.
- Train your physicians, spending one-on-one time with them during the early phases of the implementation. Working with your physicians and helping them navigate using a computer throughout the day instead of paper is not an easy task, but it is essential to the success of your EHR implementation. Overcoming years and years of practicing with a paper chart can be very difficult. Try using tablets or small computers in the exam rooms to allow the physician to have something in his or her hand but not take attention away from the patient. Some practices have also installed flat-screen monitors on the exam room wall to allow the patient to view charts, etc. Talk to your physicians ahead of time and get their opinions; you will be surprised at the outcome. Soon the physicians will notice the ease of using an electronic health record and not want to use paper at all.
- Finally, work closely with your vendor. By letting your EHR vendor know how your practice works, you allow them the opportunity to adapt to you. A good relationship with your vendor is vital to improvement and makes adjustments easier.
Remember, when you adopt an EHR, you are changing the way your practice and your physicians operate forever. Planning and preparing for the change makes all the difference.
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