How to Implement an Electronic Health Records System

What is EHR implementation?

EHR implementation refers to the integration of medical records software into a healthcare organization’s workflow. Steps in this process include selecting and preparing the EHR software, ensuring compliance with privacy and security regulations, training the organization’s care team and troubleshooting any issues that arise. Taking the time to implement an EHR solution thoughtfully will help smooth the transition and benefit your practice, patients and staff.

While some providers may be concerned about the costs and time associated with EHR systems, their implementation is vital to improving patient care and efficiency within a medical practice. EHR systems have been shown to increase the quality of care, patient outcomes and safety, as well as enhance communication between patients and providers. EHR systems also streamline the scheduling and patient data management processes, thus freeing valuable time for healthcare workers to focus on other tasks.

How long is the implementation process?

The EHR implementation timeline varies based on several factors, including the complexity of the chosen system, the size of your practice and the location of the server (cloud-based versus on-site). As a general estimate, a healthcare organization can set up a new EHR system within a year. EHR implementation for smaller practices (or modifications of an existing system) may take six to nine months, and cloud-based systems may take weeks, rather than months, to set up.

How do you implement an EHR system?

To successfully implement an EHR system in a timely manner, follow the steps below.

1. Plan your EHR implementation road map.

The first step of implementing an EHR system is to create a checklist of all the tasks that need to be completed. Carefully consider who — healthcare providers, managers, IT staff or patients — will need to complete which responsibility.

Critical tasks include stakeholder recruitment, budget planning, scheduling implementation, data transfer, training and live testing, and the establishment of go-live activities and metrics for success. Collaborative project management software, such as Google Sheets and Trello, can be especially helpful for developing a road map. Read our project management app reviews for additional product recommendations.

2. Define your budget.

The exact cost of EHR implementation will depend on both the chosen software’s features and the size of your organization. Hardware and network upgrades, vendor training and consultant fees, data backups and storage, and cost per employee can all affect your total expenses. Your budget will likely dictate the EHR solution you choose to implement. What can you realistically afford? [Read related article: How to Choose Medical Software]

You also should consider the initial loss in productivity that comes in the early stages of EHR implementation. Providers and staff will need dedicated time for training, which may come out of their patient care hours, and they may require additional time beyond that to further adjust to the new system. Once the platform is fully implemented, however, your organization will benefit from a more streamlined workflow and overall increased productivity.

3. Configure the EMR system.

Once you’ve determined a road map, identified your budget and purchased the software, the next step in setting up a new EHR solution is doing a system configuration, which is essential to accurately represent the details of your medical practice and your patients’ information within the software. That means programming the location(s) of your practice and the providers who will be using the platform.

You also need to design your practice’s clinical workflow, which includes the creation of clinical templates. Templates are required to meet Meaningful Use and Physician Quality Reporting System standards outlined by federal regulations. Following those rules is critical to ensure your practice does not incur Medicare payment penalties.

During the system-configuration phase, your EHR will be integrated with your practice management (PM) system if it’s not already. Also, any data stored within your old system will be migrated to the new one in this phase. You will need IT assistance for this.

“An important component of putting a complete PM and EHR system in place is conducting a data import from the legacy system to the new system,” Adam Siegel, a senior product manager at MedBridge, told Business News Daily. “A new software system will not automatically convert patients from one system to another. This is a complex process that must be facilitated by technical experts.”

4. Begin enrollment and credentialing.

Enrollment and credentialing, which detail how you are paid, depend partly on the responsiveness of the payers. At best, changing payer enrollment from one PM system to another will take a couple of weeks or, at worst, a few months. It’s imperative that you build enough time into the implementation process in case the enrollment-and-credentialing step takes longer than expected.

“Enrollment and credentialing is critical for accurate and consistent payment from insurance companies,” Siegel said. “The process can be drawn out depending on payer responsiveness and if the practice is represented as a group or individual providers.”

Getting this step right is crucial to ensuring smooth operations for your future revenue-cycle management, including the receipt of accurate, consistent and timely payments from insurance companies. Still, you won’t want it to push back your “go live” date, which would hinder your medical practice’s operations. Careful planning is vital. [Check out medical billing and collection tips from the pros.]

5. Optimize the workflow.

Outline each step of your organization’s current workflow. Then, ask the following questions:

• Is it necessary?
• Does it add value for the patient?
• Is it being done in the right order and by the right person?

For certain processes done by a physician, ask the following questions:

• Does this require a physician’s skills or training?
• If not, can someone else complete this task?

By optimizing your workflows before EHR implementation, you can increase the likelihood of a smooth rollout and minimize inefficiencies in the use of the system.

6. Train your team.

Even the best software is useless if staff aren’t trained on how to use it properly. Training will vary based on your practice’s specific workflows, the different roles of your staff members and their preferences for how to engage with the new system. There are several ways to bring your team up to speed, but the key is to begin training a short time before the new EHR solution goes online so staffers retain as much of the information as possible.

“Training is best done within a couple weeks of the go-live date,” Siegel said. “This ensures that new workflow and process will be fresh in the minds of the staff. … Staff interact with their [practice management] and EHR systems constantly, and it’s important that they adopt the new system and look for ways to use it as efficiently as possible.”

Training options include self-paced learning and on-site training. Self-paced distance learning, which is the most affordable and simplest method, involves reading user guides and watching instructional videos. On-site, instructor-led training is a comprehensive, in-person teaching program.

Of course, on-site training costs more, since a professional integrator must travel to your practice to teach your staff, but in-person training can provide your team with one-on-one time with an experienced instructor who knows the ins and outs of the new system. Siegel recommended less-robust training methods for smaller practices with fewer staff and on-site training for large practices or hospitals.

7. Troubleshoot the system and mitigate risk.

EHR software is complex and far-reaching, so be prepared to engage in troubleshooting and risk mitigation. As Siegel put it, “The implementation process as a core principle involves stopping revenue through one channel and restarting it through another.”

Naturally, this is a delicate and risky thing to do. Here are a few suggestions to protect yourself against some of the potential issues surrounding implementation:

• Choose a system with a user-friendly interface. An EHR system can either streamline or hinder operations in your medical practice, depending on how you use it. To ensure your new solution has the desired effect, make sure the platform’s user interface is intuitive and simple to learn. This will help make the transition easier for your staff and increase the effectiveness of your system, without depressing productivity.
• Include your staff in the decision-making process. The best way to determine how prepared your staff is to adapt to the new system is to include them in the decision-making process before you select a product. Do they find certain interfaces friendlier than others? What does their preferred workflow look like? What kind of training would they find most helpful? These questions can help you choose a system with your team in mind and make adoption of the new software much easier for them. Involving each department in your practice during the decision-making process provides invaluable insight for making a final purchase and gets long-term buy-in from your team members.
• Integrate all software with your new PM/EHR system. “Many practices use additional software products to provide the full spectrum of solutions needed to run an efficient modern medical practice,” Siegel said. “This starts with integrating any additional systems with the new PM and EHR software. Products like appointment-reminder systems and interfaces with lab and imaging systems are critical to practice efficiency and shouldn’t be overlooked during the conversion process.”
• Assess your practice honestly before implementation begins. Providing an honest and accurate assessment of your medical practice’s current finances, workflow and capabilities is a major part of executing a successful implementation. Through this assessment and the development of clearly stated goals, a practice’s administration can more effectively set and track metrics of success for the new system.

“A practice should have a clear understanding of how their complete practice will operate on the new system by the time they sign the contract and begin the implementation process,” Siegel said.

Once the software is configured and your team is trained, run through different online and offline workflows to see what issues, if any, arise. Take the time to troubleshoot and resolve those hiccups before your full rollout.

What are the benefits of a fully implemented EHR system?

At the end of the implementation process, your practice will have a fully functioning, modern EHR system that will hopefully improve both the quality of the healthcare services you provide and your practice’s profitability. Most practices implement new software only once or twice, and if it’s done right, the rewards are exceptional.

Here are some of the benefits your practice should see:

• A more optimized day-to-day workflow and friendlier user experience
• More efficient, timely and comprehensive medical care for patients
• More complete documentation of patient visits and rendered services
• Greater patient satisfaction due to decreased wait times and simplified billing
• More efficient scheduling and increased appointments, as well as reductions in no-shows and cancellations
• Increased revenue and medical claims accepted by payers on the first submission, as well as a reduction in the amount of aging accounts receivable in collections
• Improved connectivity with labs, hospitals and specialists that work with your practice

“By visualizing a modern medical practice and putting in place the right tools to manage it, a practice can put themselves in a grounded position of system optimization and excellence in performance poised for future growth,” Siegel said.

What is the best EMR and EHR software?

These platforms rank among our picks for the best medical software:

• DrChrono: The introductory tiers for this EMR platform are feature-rich and low-cost, making it a great choice if you’re new to medical software. You’ll also get free setup assistance, so the implementation process will be much easier. You can learn more in our detailed DrChrono review.
• AdvancedMD: This vendor operates on an a la carte model, meaning you can pick just the EMR and PM services you need. This flexibility can streamline implementation and save you money, since you aren’t paying for unnecessary features. Read our AdvancedMD review for more information.
• CareCloud: The tools within the CareCloud system are arranged logically, and the platform’s interface is highly user-friendly. The software is easy to use right from the start, and its extensive customizability further lowers any remaining learning curves. Read our CareCloud review to see if this EMR platform might be right for you.
• athenahealth: A major function of medical software is to generate analytics reports that you can use to make smart decisions for your practice. athenahealth excels in this area, and a company representative always reaches out to new users for one-on-one consultations. Our athenahealth review further explains how this vendor goes out of its way to serve healthcare organizations.
• Kareo: For user-friendly software at a competitive price, Kareo is a great choice. Its dashboard is notable for resembling a social media feed and thus feels familiar, and everyone in your practice can customize their dashboards. Learn more in our comprehensive Kareo review.

What lies on the other side of implementation

Your EHR implementation journey will almost certainly result in more organized workflows, larger revenue and happier patients. It’s no wonder, then, that about 80 percent of healthcare offices have adopted EHR systems. The overwhelming popularity and prevalence of this technology suggest it’s time for your practice to get on board if it hasn’t already. And with this guide, doing so should be a breeze.

Max Freedman and Sean Peek contributed to this article. The source interview was conducted for a previous version of this article.