As we reported last issue, many physicians who spend tens of thousands of dollars on an electronic health record system
don't implement it properly, sometimes giving up entirely because they can't figure out how to use it. (See "Why EHRs falter," April 7, 2006).
In this second of our two-part series, we look at the steps you should take to help assure that your transition to an EHR
is as problem-free as possible.
Don't ignore your practice management system
If you were shopping for new billing and scheduling software, you'd make sure that it worked before you bought it, right?
But sometimes, when doctors buy an EHR that's going to be interfaced or integrated with a PM system, they treat the latter
as an afterthought. Big mistake, says Ron Rosenberg, a practice management consultant in Sausalito, CA. Check out both halves of the system before
you sign a contract or you could get yourself in serious trouble.
A nine-doctor pediatric group in Savannah, GA, can attest to that. The practice, which had been using an old version of Medical
Manager, bought a new practice management system and EHR from a local reseller who promised the doctors a price break. Unfortunately,
the billing system worked poorly, and, as a result, the practice lost more than $100,000 in revenue and was crippled for three
or four months, says pediatrician Benjamin D. Spitalnick.
Don't do too much too fast
"If you're getting an EHR, you should get your staff up and running on it long before the physicians ever touch the medical
record," says Bethpage, NY, gastroenterologist David D. Gutman. When the group he was with bought an EHR three years ago,
the physicians plunged right in, but key patient information wasn't in the system yet, and the staff had to rush to enter
past histories, medications, problems, and the like, he says.
Power Points
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Rosemarie Nelson, a consultant in Syracuse, NY, advises putting in six months' worth of data before physicians start using
the EHR in daily practice. "If you have historical data in the system, you immediately add value. If you start with an empty
slate, and all of the patient's past medical and social history has to be collected when you see him, it will drag the process
out."
The other key part of readiness, Nelson stresses, is to know how you're going to perform every office function in an EHR environment.
Also, don't skimp on training or on providing computers to everyone on the staff. "When you press vendors on price, they cut
out training and hardware," says Ron Sterling, a consultant in Silver Spring, MD. "That dooms your project to failure." To
avoid this problem, Sterling urges practices to establish realistic budgets to start with.
First and foremost, the consultants agree, physicians must be committed to making the EHR work. If they're not, or if just
some of the physicians in a group are willing to take the time to learn the system, the project will be a very expensive exercise
in futility.
Watch for advisers with conflicts of interest
Power Points
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Jeffery Daigrepont, a principal of The Coker Group, a consulting firm in Atlanta, warns physicians against dealing with consultants
who are paid by or represent vendors—a practice he regards as unethical.
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