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Implementing an Electronic Health Record System.

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PMSCOThere are many steps involved with transitioning your practice to make full use of an Electronic Health Records (EHR) system. You are not loading new software; you are purchasing an information technology (IT) system for your practice. This IT system will enable you to organize your practice, both operationally and clinically - in ways you cannot do while using a paper charting system.

It is essential that you understand how your practice really works before you purchase an EHR system. Be sure that EHR will enhance your practice, not get in the way of how you prefer to operate. Conduct an evaluation of your office's current workflow processes, including patient scheduling, registration and checkout; clinical staff functions; physician encounter; lab/other test results; messaging; prescribing; billing; and transcribing. Though this step may take time, it should not be overlooked. When you know what you need an EHR system to do, vendor software demonstrations are much more informative.

There may be some staff resistance as you evaluate whether or not your practice is ready for EHR. Staff members may be afraid to learn something new, or they may fear that the EHR system will eliminate their job. They may want to hold onto the "old" ways as long as possible. Be ready to answer questions about how the system may impact each staff member.

Additionally, physicians cite many reasons why they can't use EHR. Some say it is difficult to use, or they don't type well enough. There are also concerns about making eye contact with patients. Talk to a colleague who is currently using EHR and ask them if the system has hindered or enhanced the physician-patient relationship. It is likely they will have a favorable response.

Once you have decided that your practice is ready for EHR, a work group should be created comprised of people dedicated to seeing the project through to the end. Representatives from each area of the practice should be part of the work group. These representatives should understand the details of the day-to-day practice operations.

A physician from the practice should become the leader of the work group. This physician is often referred to as the "physician champion." The physician champion should be able to motivate other doctors to embrace change. The physician champion should also educate and give the other physicians time to express their questions and concerns.

A project implementation work plan should be developed by the work group to provide guidance for the process. It is helpful for the practice to identify timeframes for completion of tasks and assign responsibility for completion of tasks. Some of the key tasks include evaluating workflow, determining timelines for reviewing EHR systems, and setting realistic dates for selection and implementation of a system. The work group should conduct research and select four or five vendors that will visit the practice and demonstrate their systems.

Throughout all these steps, the work group should educate and keep all staff members informed of implementation progress.

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