Implementing a new EMR will present many opportunities for Failure

Implementing a new EMR will present many opportunities for failure. Your challenges may or may not be at the failure level. Some will surely not appear to be what they really are.

Relatively speaking the software and technology changes in an EMR transition will be the easy part. Bringing your staff up to speed on the new EMR will take time, patience, training and retraining. It will probably take a year or more to feel comfortable with the software and perhaps longer before you have integrated most of the salient features of the technology.

An EMR is not a standalone product. It is integrated with a Practice Management System or Patient Billing System, either tightly or via an interface. The EMR is continually being enhanced to accommodate Meaningful Use, ANSI 5010 and ICD-10 as well as other features and improvements. It has links to e-prescribing, voice recognition, appointment reminder, labs and hospitals, state and local agencies for immunization reporting and more.

Your EMR is also under the control of an operating system, probably some version of MS Windows. That control is growing more useful AND ominous with every release. You have printers, fax machines which may be physical or logical, scanners and auto phone dialers. You may have tablets and smart phones attached or with remote access. Your server may be in-house, in the Cloud or provided by SaaS (software as a service).

You may or may not use a data conversion to get your data into the new EMR, either way you will face problems.

Simply stated you have a complex technology environment which is growing in its integration, data sharing and complexity. And your dependency on your "system" is becoming indispensible.

At first glance the staffing considerations do not appear quite so complex. But there are several disciplines represented in medical clinics. First are the medical professionals, doctors, nurse practitioners, physician assistants and nurses. On the business side there are the management, accounting, marketing, billing and coding, receptionist, and technology skills. In the end, people present the bigger problem with the greater number of opportunities for failure.

The difficulty presented by technological complexity can be minimized in three significant and relatively easy ways to achieve.

1. Hire professionals either on staff or as consultants, depending on your need. Do not go cheap. Do not let someone on your staff (or a relative) who seems to know a lot about computers but for who technology is not a first language, drive this effort.

2. Get it done right before you implement your EMR. Plan, test and re-test.

3. Get regular maintenance. This will cost extra up front but be less expensive in the long term. Don't wait for a problem to show itself. By then the repair work will be far greater as will its cost and you may also encounter lost or damaged data.

The challenges presented by staff require what they always have, new or revised office procedures, testing, training, hand holding, patience and time. In short it is a lot of work to bring your staff up to speed.

Office procedures need to be reviewed and revised often during the implementation process to accommodate and adjust to the software, to changes in the staff where new talent is added or a talent loss occurs, and the addition of new medical services. It is unreasonable to expect a resolution to internal changes of this nature in the first or second try. Give it some time and make adjustments as you learn.

In summary, don't underestimate the complexity of implementing a new EMR.