Implementing an EHR for multiple specialties
As we are in the midst of implementing a common EHR in the offices of several facutly physician groups at one of our hosptials, I have been thinking about how best to coordinate the configuration and design of the EHR workflows, templates and other features that must be shared across multiple different speciatlies that do not always approach their documentation in the same way. We've tried a few different approaches (some successful, some less so), but I'm interested in what strategies others have taken with this challenge.
I am in a multispecialty group. We have an EMR that allows you to assign categories to different providers/specialties. Prior to implementation/go-live, we looked at the customizable areas of the EMR (basically the whole EMR in our case - eClinicalWorks) and organized them to fit the workflow of the specialties. We assigned each doctor a list of sections/subsections (HPI - cardiology for example) based upon where they felt their strengths were, and took their input to customize the system for their specialty. The work was done taking into consideration standards of practice, proper anatomy and physiology, and correct spelling. You certainly have to look at what the base product is providing. Some systems will have a better base system than others. Even if you like the elements within the EMR, you still may want to customize things for your group's physicians so their particular workflow is supported rather than hindered (if your EMR allows you to customize sections). Back to the categories - we have 3 sets of categories - a full HPI/ROS/Exam set for pediatrics, internal medicine and surgery. Each specialty gets to adjust their sections to fit their workflow. The internists don't need to see the HPI for toddlers learning to talk and eat table food and the pediatricians don't need to see the questions about the various geriatric issues. We have been live on the EMR for over four years and the way we customized the system and divided up the categories has proven very successful. We add/adjust as we move forward, but 98% of the setup was essentially done at the start.
Using an EHR? Yes - eClinicalWorks
Disclosure: Owner/practicing partner of Aquidneck Medical Associates, Inc. Contracted as the Case Management Physician Advisor at Newport Hospital (a Lifespan affiliate) and as an advisor for BCBS of RI to help facilitate HIT integration in community practices