The use of electronic medical records (EMR) can have a transformational effect on health care in the United States. As more medical practices implement EMR systems, it is possible to use data to coordinate care, reduce inefficiencies and improve quality of care. There are some basic steps for managing an EMR implementation in a primary care setting.
Instructions:
Planning
1. Decide on an end goal. Before starting any EMR implementation project, your medical practice must have clear and realistic expectations about goals and priorities. Use this framework to create an implementation plan that will best meet your needs.
2. Build a multidisciplinary planning and implementation team. The team can make or break an implementation. A physician or other clinician should have a lead role on the team, ensuring that there is buy-in among the clinical staff and that implementation decisions are in line with patient care.
7. Test that the hardware, wiring and network are working properly. It is better to take time in advance to verify that all components are functional than to start an implementation, only to find that there are hardware problems.
8. Conduct ongoing computer training for staff at all levels of the organization. Implementing a standardized training checklist is often the best way to ensure that all staff have the knowledge and capability they need to begin the EMR implementation process. This is also a good time to solicit staff feedback about potential problems or ideas to improve the process. It is critical that the staff team be working well together and understand expectations before beginning to use the new system.
9. Establish and communicate protocols for system use and for information exchange. Staff should be clear about privacy rules and how they interface with the new system.
11. Test add-on programs or modules to make sure the system is functioning smoothly. For example, electronic prescribing and other tools are often extra modules that interface with the main system.
13. Install and test the system software. At least a few days prior to the “go live” date when the system will be up and running the first time, do a real-time run through with staff. Some practices use staff as stand-in patients to test the system in as realistic conditions as possible. This is your last chance to work out any bugs before using the system with real patients.
14. Pre-load some data for patients who have appointments in the first few weeks. This will reduce some of the stress on the first day of EMR use.
17. Evaluate workflow. It is impossible to anticipate every detail of the workflow changes required to implement an EMR system. Ongoing evaluation and staff feedback are important in order to make modifications along the way.
