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Careful selection, training help facilitate transition to EHR
One practice formed an in-office committee to take the lead and ease implementation.
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In 2009, the American Recovery and Reinvestment Act established criteria for health care providers using electronic health records. According to the U.S. Department of Health and Human Services, providers must show “meaningful use” of EHR, meaning they are using certified EHR technology in ways that can be measured significantly in quality and in quantity.
After 2015, Medicare will require that all Medicare-eligible professionals and hospitals meet meaningful use requirements or they may be subject to a financial penalty.
Without properly planning and training for EHR implementation, a practice is unable to take full advantage of all of the benefits an EHR has to offer. Proper training involves many aspects, not the least of which are involving staff in the decision-making process related to EHR, forming a committee of “super users” and designating a sufficient amount of time for training.
Involve staff members
Involving staff members in the decision-making related to EHR implementation ensures that all users have an optimal understanding of the system and its functions. At Horizon Eye Specialists & Lasik Center in Phoenix, we have a staff of four ophthalmologists, four optometrists and 20 technicians. They can all provide insight on documentation needs for patient care to ensure the transition is a success.
In 2011, we transitioned to our EHR (ManagementPlus) from an electronic medical record (EMR) that was designed by the same vendor in order to comply with the meaningful use requirements of the Affordable Care Act. In preparation for our transition to EHR, an ophthalmic technician and I visited a practice that had already implemented our selected EHR, and we observed them using the system with patients. This helped us better understand how the EHR would merge with our practice’s workflow.
Designate a committee
The technician and I immediately returned to our practice and formed a committee of four technicians to act as super users. Committee members were selected on a volunteer basis and if they exhibited proficiency on our previous EMR system. We decided on a committee of super users vs. a single super user because we believed that the more users we had, the easier it would be for staff members to obtain assistance in a time of need.
Jeffrey L Girardin
Committee members were the first individuals to be trained on the EHR, and after it went live they were considered to be the first source of information to answer questions, train new employees and communicate with our EHR vendor.
In addition, the committee was tasked with analyzing the various screen options and designing the EHR program by tailoring it to our specific needs. When the committee decided on modifications that would improve practice efficiency, they notified the vendor who then would update the software within 24 hours. To bring the rest of our staff up to speed with modifications, we initiated weekly “lunch-and-learn” meetings over a month-long period to demonstrate the changes and provide in-depth training.
Implementing training
Our training protocol consisted of three sessions of training with our EHR committee. During this time we tested various scenarios, such as ordering common tests and procedures and patient check-in, so that these processes began to feel natural for staff members. Taking into consideration the EHR’s impact on our workflow, we decreased our schedule to 10 patients a day for 1 week, which provided extra time during the day for our physicians, technicians and administrative staff to become accustomed to the new system. Following 1 week of operating on a reduced schedule, we were able to transition with ease and conformability.
Overcoming EHR challenges
Because we had been using an EMR for 10 years prior to the transition, we were accustomed to the system interface. It was challenging to introduce a new system to staff members that could be adopted fairly quickly; however, slowing down our schedules improved the rate at which staff retained the new information. We were able to pinpoint minor areas of improvement by moving certain fields and points of data to new screens to improve efficiency and the flow of the patient examination.
Ongoing training
EHR training is an ongoing process. As we grow and learn as a practice, physicians and technicians still notice areas where the EHR could be tailored to better fit our needs, and having a modifiable system is key.
For example, we have a cornea specialist, a neuro-ophthalmologist and a general ophthalmologist surgeon in our practice, all of whom perform refractive and cataract surgery. All of those specialties require additional fields and data that are not always part of a routine ophthalmology or optometry examination. Additionally, our optometrists require specific fields for specialty contact lens fittings and sets.
As a practice with many specialists, we must continue to modify our system and train staff to understand those modifications so that we can better treat our patients. Ongoing training is key to ensure we are continuously optimizing the uses and capabilities of our EHR.
When considering the training process for EHR, start early, select a system that is modifiable to your practice’s needs and form a committee of proficient staff members to build morale and maintain a positive outlook.
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- Jeffrey L Girardin, OD, practices at Horizon Eye Specialists & Lasik Center in Phoenix. He may be reached at jgirardin@horizonlaservision.com.
Disclosure: Girardin reports no relevant financial disclosures.