EHR Adoption - Planning

Planning to acquire an EHR requires clear goals and detailed research.

Whether it is what college to attend, in which neighborhood to live, or what type of car to buy, you do research before making an important decision. Plan to do extensive research before making a large HIT investment in your practice, too. Your EHR will be used in nearly every workflow at your practice, which makes it crucial that the system matches your practice’s needs and work style.

Sections:

• Get a Readiness Assessment
• Identify a Physician Champion or Steering Committee
• Motivate Staff
• Analyze Workflow
• Determine Equipment Options

Get a Readiness Assessment

Depending on what stage you are in the EHR planning process, your practice may benefit from a readiness assessment done by one of the pre-qualified technical service consultants in RI REC’s Vendor Marketplace. 

Readiness assessment consultants:

• Identify a practice’s strengths and weaknesses to determine the actions and services needed to implement an EHR, and
• Assess a practice’s core competencies in management, leadership, operations, and technology to provide a detailed report of the findings to review with the practice.

If you are enrolled in RI REC’s EHR Adoption Program, you may be eligible for a subsidy payment after completing a readiness assessment. For more information, contact your REC Relationship Manager.

Identify a Physician Champion or Steering Committee

The role of a Physician Champion is to keep the office focused and positive during your EHR planning and implementation. The Physician Champion should be a proponent of the EHR and the leader in working through obstacles during the implementation.

Another option for larger practices/organizations is to form a Steering Committee. Including representatives from all facets of the practice makes it more likely that everyone will become proponents of the EHR initiative. The Steering Committee should plan to meet regularly to make sure everyone is still on track with the project timeline. As the process continues, more frequent meetings may be needed as concerns or issues arise.

The Physician Champion/Steering Committee should:

• Create a vision for the practice’s EHR use
• Determine realistic project objectives
• Determine the strategies for data transfer and how and when to go-live
• Ensure accountability for the project’s objectives
• Assist clinical staff in modifying their workflow
• Create a training curriculum
• Generate enthusiasm and buy-in among all practice staff

Motivate Staff

Physicians who own and run their practices often find that the most challenging part of their work is managing and motivating office staff. In most practices, the burden of paperwork is overwhelming, and the successful operation of the typical medical practice depends heavily on the skills of the employees and their ability to multitask in an office with few automated functions. Emphasize to your team that using an EHR can help automate many routine, time-consuming tasks, as well as improve more complex processes.

Analyze Workflow

As practices migrate from paper records to an EHR, change is constant. Everyone in the office will perform a major portion of his or her daily work differently. Much of the economic benefit of HIT derives from the reorganization of daily tasks, as staff and providers substitute time-consuming, manual processes for technology.

Workflow redesign is your opportunity to determine how the EHR system can optimally be used to improve operational efficiencies. Use tools like lists and flow charts to look closely at patient flow, point of care, documentation, and communications. For example, the paper chart in the bin no longer will signal to the physician that the patient is ready to be seen. Determine what effective electronic processes you can use instead.

Consider the following questions when deciding how to redesign your office workflow:

• How will patients’ medical histories and the history of their present illness be entered into the EHR, and who will enter it?
• When we use an EHR and incorporate new hardware, how should the exam rooms be arranged? Where will the provider sit in relation to the patient? How can data entry be set up so that it does not intrude on patient-provider communication?
• Do we want to communicate with patients via e-mail? What are the requirements for Health Insurance Portability and Accountability Act (HIPAA) compliance in patient e-mails?

Determine Equipment Options

When considering your hardware options, use your workflow analysis to answer important questions about the best position for equipment in exam rooms, such as

• Where will patients sit?
• Do patients want to see the screen during their appointment?
• Do you prefer typing, using a tablet PC, or both?

The answers to these questions will help determine which of the following hardware best meet your needs:

If you are a member of RI REC's EHR Adoption Program for eligible PCPs, we will help you every step of the way. Visit the EHR Adoption Program section of our website.