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How to Implement an Electronic Health Records System

Adam Uzialko
Adam Uzialko
Freelance Editor

The healthcare industry's transition from paper records to electronic medical records (EMR) has been a rocky, winding road. While electronic health records (EHR) systems have been the bane of some healthcare providers existences, their implementation is essential to maximizing profits and delivering a modern standard of care to your patients.

Fewer stages of the EMR adoption journey are more arduous than the implementation phase. This phase is where the most problems occur and where shortcuts could lead to catastrophic issues later on. A botched EHR implementation can damage your revenue cycle for months, reduce patient confidence and harm your relationships with other health care providers. Moreover, a failing implementation might cause you to incur penalties from the federal government if your interim record-keeping doesn't meet regulatory standards.

Here's how to make sure your medical practice avoids a crisis scenario when transitioning to a new EHR system.

Editor's note: If you need help choosing the EHR system that’s right for you, use the questionnaire below to have our sister site, Buyer Zone, provide you with information from a variety of vendors for free.

Steps of implementation

1. System configuration

The first step in setting up a new EHR 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 in the location(s) of your practice and the providers who will be using the system. 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 is not already. Also, any data stored within your old system will be migrated to the new one in this phase.

"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, an EHR consultant, told Business News Daily in an earlier interview. "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."

2. Enrollment and credentialing

Enrollment and credentialing, which details how you are paid, depends to some extent on the responsiveness of the payers. At best, changing payer enrollment from one practice management system to another will take a couple of weeks, and at worst, the process can drag on for a few months. It's imperative that you include enough time in 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 pushing back your "Go Live" date, which would hinder your medical practice's operations.

3. Training

Even the best software on the market is useless without staff that know how to properly use it. Training will vary based on your practice's specific workflow, the different roles of your staff members and their preferences on how to engage with the new system. There are several different ways to bring staff members up to speed, but the key is to begin training a short time before the new EHR goes online, so staff members 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 range from self-paced distance learning, which is the most affordable and simplest, to on-site, instructor-led training, which is a comprehensive, in person program. Self-paced distance learning involves reading user guides and watching instructional videos, which will help teach your staff how to use the new system. Of course, on-site training costs more, since a professional integrator will travel to your practice to train your staff, but it will ensure that even large staff gets one-on-one time with an experienced instructor who knows the ins and outs of the new system. Siegel recommended choosing less-robust solutions for practices with a smaller staff and going with on-site training for large practices or hospitals.

4. Troubleshooting and risk mitigation

Even with the best planning, problems can arise. EHR software is complex and far-reaching, so be prepared to engage in troubleshooting and risk mitigation. As Siegel puts 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 friendly user interface: Any EHR system can either streamline or hinder operations in your medical practice. To ensure the new system has the desired effect, make sure the user interface of whichever system you choose is intuitive and simple to learn. This will help make the transition easier for your staff and increase the effectiveness of your system, all 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 by including them in the decision-making process. 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 staff in mind and will make adoption of the new system much easier for them in the end. Involving each of the different departments in your practice during the decision-making process provides invaluable insight when making a final choice.

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."

Honestly assess your practice before implementation begins: Providing an honest and accurate assessment of your medical practice's current finances, workflow and capabilities is a major part of devising a successful implementation. Through this assessment, and during the development of clearly stated future 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.

The payoff 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 be a boon to both the quality of health care services you provide and your practice's profitability. Most practices will have to go through implementation only once or twice in their entire lives, and if it's done right, the rewards are exceptional.

Some of the benefits your practice should realize are:

  • 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 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.

Looking for an electronic health records system for your medical practice? See Business News Daily's best picks for EHR systems.

Editor's note: If you need help choosing the EHR system that’s right for you, use the questionnaire below to have our sister site, Buyer Zone, provide you with information from a variety of vendors for free.

Image Credit: Have a nice day Photo/Shutterstock
Adam Uzialko
Adam Uzialko
Business News Daily Staff
See Adam Uzialko's Profile
Freelance editor at business.com. Responsible for managing freelance budget, editing freelance and contributor content, and drafting original articles. Also creates product and service reviews to assist business.com readers in buying decisions for their businesses. VP and co-founder of CannaContent, a digital marketing company dedicated to the cannabis, hemp, and CBD industries. Focused specifically on the content marketing arm of the company, creating blogs, press releases, and website copy for clients spanning the entire supply chain. Avid fan and indispensable ally of the feline species. Music lover, middling guitarist, and unprompted vocalist. Miniature painter who loves sci-fi and fantasy. Armchair political philosopher with a tendency to read old books written by men with unusually large beards. Ask me about all things writing!