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Set specific goals, timeline to integrate an EMR system
Understanding what each member of the practice wants out of a system aids the integration process.
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SAN FRANCISCO — Electronic medical record systems can offer value to an orthopedic practice in terms of faster record retrieval and communication. But orthopedic surgeons should first do some soul-searching to decide the initial reason for wanting this technology and what they ultimately want to accomplish with it.
“The big challenge, and this is true across the board, is that many physicians will purchase an electronic medical records (EMR) system and only use one portion of it,” Rosemarie Nelson, principle of the MGMA Health Care Consulting Group, said.
She discussed the process of implementing EMR systems in a practice management symposium prior to the American Academy of Orthopaedic Surgeons 75th Annual Meeting.
Nelson said orthopedic surgeons should approach the process with a specific timeline and goals.
“For those who have not begun the process of looking for an EMR system and those who might be feeling some pain toward having to do it, go back and survey your colleagues,” Nelson said. “You have to ask them, what is the objective here? Why do you want to integrate EMR? What is it you are trying to fix in your current practice situation? What are you trying to resolve?
“You have to know what you are trying to achieve so you can implement the right solutions and system,” she said. “Otherwise, it’s not going to work.”
No holdouts
It is also essential to have everyone on staff participate in this critical self-examination of the practice, because implementing an EMR system will affect everyone, she said.
She said you can learn a lot about your colleagues and staff simply based on how they respond to your inquiries.
“You can tell by the responses who prefers to use e-mail and who constantly uses abbreviations because they don’t like using the keyboard. That tells us something about what kind of EMR system might work best in that particular office,” she said.
Nelson said the goal-setting process can be eye-opening but it also creates a team atmosphere.
“You have to work on this together,” she said. “It makes everyone think, ‘How do I want to take advantage of EMR?’ And then that goal provides you with a measuring stick to ask, ‘Are we achieving what we set out to do, or have we picked the wrong solution? Do we need to go back to the [product supplier] and ask for help?’”
No overnight solution
One of the biggest challenges in integrating an EMR system is getting the program up and running with as little disruption as possible to the day-to-day operations of a busy orthopedic practice, she said.
“This is the tough part because no one wants to have their productivity and caseload affected,” Nelson said. “We can work with a clinic that has really thought the process through and come up with some good solutions, but realistically, for a busy practice, count on the implementation process to be about 18 months.”
One bright spot: “You don’t have to do it all at once,” she said. “You can integrate new aspects of your program a little at a time.”
For example, some physicians may resist the thought of eliminating transcription altogether.
“In this case, don’t focus on eliminating transcription,” she said. Instead, consider building an EMR system for storing other records such as appointments and patient histories, but keep transcription separate.
“It doesn’t have to be all or nothing with EMR,” she said. “You can customize the process according to what is important to your practice. This might be the best way to convince the hesitant partner – that integrating EMR doesn’t mean they will have to give up his or her transcriptions.”
Needs of the majority
When calculating the risk of adding a system, “Use the 80/20 rule: Don’t design a solution for 20% of your cases,” Nelson said.
It is easy to become enamored with some of the EMR technology, “but you always want to keep in mind that your [system] should meet the needs of the majority of your patients.”
Perhaps the biggest take-home message — and misunderstanding — is that establishing an EMR program in the office is not first and foremost a technical project.
“This is very important to understand. Too often, physicians get spooked about the EMR concept and get scared away from it,” she said.
“It is not about plunging in and getting the most expensive system; there is no one-size-fits-all approach to this. It is about setting goals for your practice and taking steps to reach those goals, with the ultimate aim of improving the patient’s experience in your clinic,” she said.
Editor’s note:
This article is part of an ongoing series focusing on implementing EMRs in the orthopedic workplace. Go to ORTHOSuperSite.com and use the keyword ‘EMR’ to view earlier articles in this series.
For more information:
- Rosemarie Nelson, principal, MGMA Health Care Consulting Group, can be reached at 114 Janet Drive, Syracuse, N.Y. 80112-5306; 315-391-2695; e-mail: RosemarieNelson@alum.syracuse.edu.
Reference:
- Nelson R. Implementing EMRs. Practice Management Symposium for Practicing Orthopaedic Surgeons. A pre-meeting symposium to the American Academy of Orthopaedic Surgeons 75th Annual Meeting. March 4, 2008. San Francisco.