The Path to Paperless

Planning a Nimble EMR Project

Glitches will surely arise, so build in flexibility.

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

Probably the most common question I have received while writing this column has been, "What's taking your practice so long to implement your EMR system?"

What we initially planned out as an 18-month-long project turned out to be more like 3 years. And although this just seemed a bit overly cautious to our colleagues, experts in the project management and information technology (IT) industries who we dealt with have generally commended our gingerly approach.

Slow and Steady Works Best

It is well-documented that EMR implementations have had a failure rate ranging from 30% to 50%, depending on what source you choose to quote. So, it is important to have a well-constructed plan in place and to take into account any contingencies that may affect your timetable. In our case, these included two hurricanes, the arrival of two new associates and the departure of another.

Your EMR vendor may be able to suggest someone who can help guide you through the implementation process, but the person recommended to you could range from someone with experience in shepherding EMR projects for ophthalmology practices to to an individual who knows the specific EMR system well but has little experience in actually rolling it out for a medical practice.

However, with any project of this magnitude, I strongly recommend hiring a certified project manager (www.pmi.org ). One of the things a project manager will do is turn your EMR project into a Work Breakdown Structure (WBS), a dynamic process that can withstand a flurry of setbacks and delays. This cannot be easily done using a standard calendar.

The Value of a Good Project Manager

We first used a project manager for planning a new office location. Our staff was able to use what they learned from that process, including how to use mind-mapping software (www.mindjet.com) for all subsequent major projects that our practice has had since, including our EMR implementation. For minor sub-projects, including meetings, I also highly recommend David Allen's action management method of Getting Things Done or GTD, which can be found at www.davidco.com.

The advantage of using a WBS is that any little (or major) hitch that comes along will not completely scuttle your goal of successfully implementing your EMR system.

Obviously, the smaller the practice, the more flexible the schedule. I am not saying that you shouldn't have a hard deadline for your EMR rollout, but with proper planning your plan can roll with the punches instead of rolling over.

Once we had all of our pieces in place and our staff was trained, we set a hard deadline for going live. Although our WBS could have theoretically allowed us to push the launch back had there been a major problem, it actually helped keep us on track by exposing potential risks to the project that could have tripped us up.

We are now about 5 months into our EMR rollout. We are currently working on tweaking our templates and preparing for the next wave of patient types who we will introduce into EMR. In next month's column, I'll discuss how to gradually introduce the new EMR system into your existing clinic workflow. OM