The Path to Paperless

Getting Ready for EMR Rollout

A step-by-step approach to going electronic.

By Peter J. Polack, M.D., F.A.C.S.

Any project as big as implementation of electronic medical records (EMR) requires a specific timeline to make it happen. A concrete "go live" date makes it easier to get everybody on board and motivated for what will certainly be a highly stressful event.

You will need a designated project manager in charge of the implementation project. This can either be an existing employee (your head IT person or your clinical supervisor) or an outside consultant. And you need a plan: the when, who, what, where and how of your EMR rollout.

When to Rollout

Before you pull the trigger on EMR, make sure all of your assets are ready to go. It only takes one missing or ill-prepared component to scuttle your well-laid plans.

Are your people ready? Your go-live date should allow at least a month of prior intensive training of the staff. Depending on the size of your practice, you may need to either rotate employees during the workday or have them train after hours and pay them overtime. Supervisors will then need to determine if they are sufficiently trained, or certified, to work with the EMR system in a real clinic setting. They will then need time to practice to keep their skills up-to-date.

Are your buildings ready? If you have been following along with this column, you know your facilities need to be properly wired with network cable and your wireless infrastructure tested and ready to go. And don't forget to add up all of the devices you will be using in each location so you're sure to have adequate bandwidth.

Is your hardware ready? Desktop computers set up and configured? Wireless tablets in your possession? Software properly installed and tested? Has your backup system been tested? Do you have a disaster recovery plan in place?

When everything is set, you can proceed to actual rollout. Whoever is spearheading the project will need to decide when the physicians will rollout: all at once or staggered on different days. While some doctors may be comfortable allowing their colleagues to take the lead, this may lead to more work and stress for the staff. If one doctor sees a patient using an electronic record and then that same patient is seen in follow-up by another doctor who is still using a paper chart, how will the patient's chart be reconciled?

If you don't relish the idea of going electronic overnight, you may want to consider designating only certain patients who will be seen on the EMR system. We opted to start with just new patients to prevent our clinics from coming to a screeching halt. As these patients return for follow-up visits, they would continue to be seen using the EMR.

Where to Rollout

If you have more than one location, you may choose to implement EMR at one office before launching at the others. On the other hand, if you have staff members who rotate between the different locations as ours do, your training plan must take this into account. In addition, if too much time lapses between separate office rollouts, training skills may suffer. Since we were starting with only new patients, we decided to rollout at all the offices simultaneously, so that the clinics would not be affected by differences in staff training skills. OM

Next: How to conduct rollout.