I’m often surprised by how some medical practices are so casual in their approach to selecting an EHR system. As if the EHR selection process itself is inconsequential. And I’m bordering on terrified when I hear the physicians and staff of these practices say something like, “Implementing an EHR system will solve the majority of our operational problems.” The fact is … nothing could be further from the truth!
Anyone can select from the many EHR systems on the market today and implement its use. But doing so successfully … so as to improve both patient care and practice operations, takes some serious and formal due diligence. And skipping steps in the process, or making incorrect assumptions, are almost a guarantee that you’ll be the next poster-child for EHR failure. There’s a reason, many reasons, why 20% of EHR’s end up being uninstalled.
EHR systems will inherit and compound problems that currently exist in your practice.
One frequently overlooked step in selecting the best EHR system for your individual practice’s needs is conducting an Operational Analysis. It’s an excellent way to document your current systems of operation and to identify problem areas that may be well addressed via the eventually implemented EHR chosen by your practice. Knowing those issues prior to the selection process is critical in understanding your needs as you compare the many options. It’s also invaluable to you and your EHR vendor during the implementation process.
Most EHR systems will help you improve the way you do things, and improve your documentation and compliance. You may want, however, to retain some processes that are unique to your practice. Consequently, as part of an Operational Analysis you should be sure to have your workflows well documented. Having this information available to the EHR system vendor will make the implementation process go much smoother, and help you get a system that improves the patient care available in the office and increase the efficiency of that patient care.
An excellent way to document your current processes is to use flow charts. But even a short written description of how you do things will be very beneficial and should include:
- Patient Appointment Scheduling
- Patient Reception, Check-in and Check-out, Nursing, Medical Assisting, Patient Intake and Follow-up
- Medical Records (filing chart material, preparing for visits and post-visit follow-up)
- Physician Activities during Patient Visits (chart use, documentation, billing information, patient prescriptions and educational materials)
- Physician and Office Practices (laboratory, X-ray and other diagnostic reports and follow-up, dictation, transcription, prescription refills, patient phone calls, referral tracking, etc.)
- Data Entry of Patient Charges
- Billing of Charges
- Payment Posting
- Accounts Receivable Follow-up
- Patient and Insurance Company Collections
Physician office workflow will change with an EHR.
That being said, it’s difficult to anticipate what exactly will happen to your workflows when you switch to an EHR system, especially if you have never used one in the past. Many things will be similar with only slight differences. Other processes will become more complicated or extensive, sometimes because more information is required in the new system, sometimes because other staff must now participate, and sometimes because you are now doing things that didn’t get done previously, like following up on referral requests, or patient referrals to outside testing. In any event, things will change. The trick is to accept that some change is inevitable, so keep your focus on the big picture and don’t sweat the small stuff!