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It is important to have staff involvement to implement an EMR (electronic medical records) system properly. No single person can realize this job single-handedly, no matter how skilled they are. Staff members will be aware that a new EPM system will have a sweeping effect on billing and scheduling. They will understand the risks that they are coming up against, and may feel pressure. The owners and administrators should understand the concerns that employees will raise when discussing a new system. At times we experienced resistance from staff members. A group of power-users should be created. These people should be the first ones trained on aspects of the new system, who then take the example to the rest of the staff members. These power-users should come from a variety of areas: 1) Information Technology
2) Administration
3) Office Staff
4) Clinical
5) Front Desk
6) Compliance In order for the new system to succeed, this committee must take charge of the project. Our practice formed a committee which could hold meetings as it saw fit. This group of people had taken the project from the very beginning, and some put in evenings and weekends as they had the power of decision-making and the responsibilities that come with it. Confidence in individuals and the group grew. Some key players include: Front Desk Staff They provide valuable input from the perspective of the end-users of the EPM; their tasks include check-in, check-out, posting of charges, and scheduling. Their critical job at the present time is the manual posting of the charges at the time the patient checks out. This will be even more significant in the near-future when the EMR module posts the charges automatically in real-time. Having the time to get the bugs out of this process helped to support our initial decision to postpone the implementation of the EMR until the staff was well acclimated to the new EPM system. Clinical Staff Although not as vital during this phase of EPM conversion, their participation will be key to the success of the integration of the EMR into the practice in a few months. Nevertheless, it is important to for them to be involved in the early stages of planning; it is helpful for them to have an appreciation for what the non-clinical staff does and how the EMR will fit into the entire scheme of things. IT Specialist This person should be involved from the beginning, prior to choosing the EMR software. If a practice cannot initially justify the expense of a full-time IT specialist, an IT consultant should be retained. Because we knew that conversion to EMR was just part of our overall strategic plan, we felt that we could easily justify hiring a full-time IT specialist; in fact, due to this person's expertise in such areas as software licensing, Internet communications, and hardware networking, the changes that were incorporated into the practice eventually paid for his annual salary. Coding/Billing Specialist These employees should also have a voice in the initial software selection process. They helped to minimize the hiccups we experienced when we switched from our old EPM system to the new one. On their recommendation, we performed a trial run on the new system (soft "go-live") prior to completely abandoning our old system. This allowed our IT specialist to verify that the posting and billing were being performed correctly. Someone technically proficient with coding and compliance issues will also be invaluable when the EMR module of our system goes live to prevent under- or over-coding and ensure HIPAA compliance. The physicians in our practice felt it was essential to empower the EMR committee with the authority to plan and manage the EPM/EMR integration from the beginning. The managing partners meet on a regular basis with our administrator for status reports but oversight of the nuts and bolts of the entire process is handled in a laissez faire manner. As mentioned previously, the success of this project depends in large part on the involvement of all members of the organization.
Peter J. Polack, M.D., F.A.C.S., is founder of emedikon, a medical practice management consulting firm and president of Protodrone, a software development company specializing in medical practice applications.
By the way, do you want to learn more about implementing EMR in your own practice? Download my free report "Getting Through The EMR Maze."
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