| Successful implementation of an electronic medical
records system involves some planning and patience. The first strategy
you must decide on is whether to jump in with both feet or evolve into
your new system.
For a brand new clinic, full immersion or using the new system exclusively from the start is clearly the better choice. There is no need to develop two systems in a new office, plus you are likely not operating at full capacity in the beginning and can therefore take a little extra time to become acquainted with your new system. For an existing clinic, full implementation can lead to disastrous outcomes. In order to attempt jumping right in, the existing clinic will have to lower the amount of patients seen, and will likely suffer multiple frustrations from trying to change workflow processes in a single attempt. For the existing clinic, the better choice is evolution, or incremental implementation. Evolution involves using both systems on a small number of patients. It’s much easier to commit to using the new system on one or two patients a day than trying to use the new system on your busy schedule. You will not experience the workflow disruptions, your staff will not be under undue pressure and you’ll be able to let the most computer savvy individuals on your team to take the lead in learning the system. |
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These individuals will evolve into your in-house experts on the new system; they will be of great benefit training other staff members. As you explore and become familiar with using the system you will have a more knowledgeable basis to request any small, logical customizations to the system. It won’t be a crisis; it will be a strategic choice. The new system should help you operate the way you choose, it should not dictate how you operate. As you become comfortable using the new system on a small group of patients consider how you will expand the number of patients using the new system in a logical, methodical progression. Given a few months you will have evolved into the new system with few headaches. We find that allowing 4-6 months for incremental implementation is a successful strategy for existing clinics.
Your clinic needs one or more prominent physicians to champion the use of the
new system. It is imperative that you have at least one motivated physician on
board with using the new system. Without such a person, the implementation
process is likely to fail, and you’ll end up with a new system that is not being
used. This individual will introduce the system to your slow adopters, or
computer resistant personnel as the case may be. This physician will be the go
to specialist on the new system for other providers.
You will benefit from champions in other positions, i.e., front office and back
office personnel and especially in the billing department.
While our goal is eliminate as much of this as possible, paper based information
coming into your office still needs to be dealt with. In an existing clinic you
have a method in place to handle your paper based information. To your existing
method you’ll need to incorporate scanning the information into the new system
as well as shredding and destruction of the paper. The good news is that you get
to eliminate the processes of placing the information in the paper chart and
filing it. It is best to continue your current workflow for your paper based
information, just scan and destroy rather than operating the paper chart.
In general, we see an over-emphasis on the part of customers on handling of
scanning and destruction of the old charts. Since the best implementation method
for an existing clinic is via an incremental method, there is no hurry. Our
recommendation is to prepare an area for scanning and elimination of the paper
material. We have found the Visioneer scanner to be an inexpensive, reliable and
very fast sheet fed scanner. You have the option of scanning the old information
into the computer and either uploading into your new system or just make DVDs
which you can use at any workstation that needs potential access to the old
information. In our experience, you can get about 1,000-2000 charts onto a dual
layer DVD. By using DVDs you can bulk store the information much faster because
you can eliminate the process of locating the specific patient in the new system
prior to scanning. As time goes by, you’ll need the information from the DVDs
less and less.
With our internet based system, you’ll need some basic router to distribute
internet access. Encrypted wireless routers have worked well for many practices,
and they allow for use of a wide variety of computer hardware. Tablet PCs at
first glance seem sexy and functional. However, we have found a number of
practices change back to stationary hardware for each room after initially
trying out tablets. Some practices do fine with tablets. Therefore, our advice
is if you’re thinking about using tablet PCs, go slow, start with one and try
using it actively in your practice. It will soon become apparent if tablets are
going to work for you.
