How can you recognize early on that an electronic health records implementation project is in trouble? That’s the subject of an educational session during the MGMA 2013 Annual Conference, Oct. 6-9 in San Diego.
Carolyn Hartley, president and CEO at consultancy Physicians EHR Inc. in Cary, N.C., will describe the seven symptoms that you have a problem and what to do. The symptoms cover such functions as new patient registration, rooming the patient, charting and documentation capture, computerized physician order entry, messaging and triaging incoming calls, night clinics and walk-ins, and patient portals/patient engagement.
Take rooming the patient, for instance. In a paper world, the nurses and physicians have difference processes. One physician may want a nurse to capture most of the routine information of an office visit, while another physician may say “check blood pressure and I’ll do everything else.” But in the electronic world, that means data is being inconsistently entered into the EHR, and it gets worse if one nurse is substituting for another that usually works with a specific physician. Consequently, practices going electronic need standard processes. “Without internal governance standards, the EHR will be a mess,” Hartley says.
Messaging and incoming calls is another example of how there can be too many ways of doing the same thing. The paper world has sticky notes or internal email. With messages now going in the EHR, one physician may want all messages sent to a specific nurse with the physician also getting the messages. Another may want all messages sent to the nurse. And another may want every message sent to him, but then wind up calling someone and complaining, “I received 200 messages today, how am I supposed to deal with that?”
So, physicians need to prioritize and standardize, Hartley says. “The front office knows how to triage calls--let them manage it. They know when to alert the doctor. The EHR should not replace good communication.”
The consultancy does a lot of “rescues,” coming in when an implementation or rollout is not going well and there is a lot of finger pointing. But there is one factor that is missing in most practices that need a rescue, Hartley asserts. “Leverage the staff to their highest credential capability. They know what they are doing. Let them knock on the door and say there is a call you need to take.”
The session, “Seven Symptoms of a Troubled EHR Implementation and What to do About It,” is scheduled at 4:00 on October 7.
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