Over the last couple of weeks I have been running across various success and failure stories of EMR implementation in various settings, ranging from small practices to large hospital wide implementations.
The number one factor in a successful EMR implementation from all the read reports have been due to physician/surgeon buy in. Makes sense, after all these are end users of the applications and if you don't have anyone on the provider side vying for a successful workflow adaptation, there is no reason to implement an EMR. Also, if you have an M.D. as your champion, won't the rest of the staff have to buy in for fear of replacement of someone who will? I know in other occupations, what the boss says, goes. The true is same in healthcare, no?
The next seemingly most important factor is the ability to customize the application in a way that will best benefit the providers. This is absolutely a main component in the success factor of an EMR in my opinion. Vendors have to do what they can to include everything in their system that a practice, clinic or hospital may use.
In a hospital system, this problem is very clear. A hospital system has to be a nightmare to the specialists who use it. Why would a provider want to sift through literally thousands of medications when they typically only prescribe certain ones for their patients. This is where careful planning and delegating comes in. The customer needs to understand that the hospital system is meant to meet the needs of all providers in the entire system. It is recommended that each specialty department within the community appoint select staff to create a list of "Favorites" within the medications, procedures, diagnosis, orders etc. tabs. This way, time will be saved when completing a patient visit.
In a smaller setting, I have to recommend going with a specialty specific vendor. In doing this, the provider will have a more robust system specifically catered to their needs and will not include any additional data fields that they will never have a need for. The specialty specific vendors are also more likely to already have certain reporting tools already preloaded in the system to generate specialty specific and relative reports, such as those required for Centers of Excellence. Exemplo Medical (www.exemplomedical.com) is one such company that develops specialty specific software. For example, Exemplo's application for Breast Cancer, eMD for Breast Centers, is an application designed in conjunction with Breast Surgeons and staff that only shows pertinent workflows that a typical Breast Center or Practice may use. The workflow includes specific data fields for patient visits, orders, medications, procedures and so on. They even have a specific report that automatically generates a NQMBC report that is easily submitted to the National Consortium of Breast Centers for their COE compliance.
Of all the success stories these two themes: provider buy in and customization seem to be at the top of the list and perhaps the easiest to attain. Some may disagree with that statement of being "easy to attain" however if a provider has been given a clearly painted picture of the benefits of EMR implementation, then it should be a no brainer on their end. As for the customization...providers do your homework, there are wonderful systems out there that you will be amazed to find how easily adaptable they are to any practice.
Monday, April 26, 2010
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