The incentive money is there to implement EHRs, but most HIM professionals and hospital executives know that deploying the technology is not as simple as pressing a button to go live.
Several industry experts have weighed in on this question: What is the single most important tip you could provide to someone regarding an effective EHR implementation? Their answers, summarized below, are quite telling.
Tip #1: Realize that the EHR will not solve your problems.
"EHRs do not necessarily fix poor processes, but rather, they tend to expose them. Create workflows that depict current scenarios and then revise those workflows once you've implemented the EHR. Use a team approach with IT, HIM, physicians, nurses, and other users of the EHR."
–Jean S. Clark, RHIA, CSHA, service line director for HIM at Roper St. Francis Healthcare in Charleston, SC
"One of the most significant mistakes a provider can make is to implement the EHR so it matches the current practices and workflow. This is a new tool, and providers must map how the business/medical practices must change to increase quality and efficiency before selecting a vendor. This will help them take advantage of the tools the technology has to offer and assist them in finding the right EHR that addresses the specific practice/business needs.
"As an example, one of my clients completed the business process analysis and examined what it needed to improve the practice. In this case, the EMR needed to accommodate sound prescription management, given the client operates a pain clinic. Without the initial assessment, the client would not have necessarily selected an EMR that suited its needs and allowed it to address quality and efficiency.
"The bottom line is it is generally far more important to complete the business analysis rather than jumping right to the implementation phase."
–Chris Apgar, CISSP, president of Apgar & Associates, LLC in Portland, OR
Tip #2: Identify EHR stakeholders and involve them in the implementation process.
"Solicit input from those who you know the EHR will affect."
–Kelly McLendon, RHIA, president of Health Information Xperts in Titusville, FL
"Involve every department that touches a medical record or uses it in any way. Start with the administrators and directors, but be sure to solicit input from end users—especially when you begin to customize the system."
–Donna Walker-Thomas, MBA, RHIA, CPC, CMA, manager of coding and transcription for William W. Backus Hospital in Norwich, CT
"Create a steering committee that represents all end users of the proposed EHR system. The capital and political costs associated with EHR implementation are so substantial that a rush to implement can be extraordinarily expensive and, if done poorly, can sour an entire medical staff to any EHR technology. The planning team should also include experienced technical advisors and legal counsel so that the final implementation plan does not include technical or legal time bombs that go off just before or during cut-over."
-William Roach, Jr., MS, JD and Heidi Echols, McDermott, Will & Emery, LLP in Chicago
Tip #3: Keep it simple with as few systems as possible.
"Our challenge was that we had too many systems. We began our EHR implementation in 1991 by scanning medical records into the electronic patient file (EPF). After that, many other systems have been implemented to create a truly electronic system. Several of the new systems have not been able to feed into the EPF. We have either had to print and scan documents into the EPF or go to that separate system to retrieve records. This is very cumbersome for record requests."
–Phyllis A. Santillanez, RHIA, HIM director for Kaweah Delta Medical Center in Visalia, CA