The Path to Paperless

The Five “P”s of the EMR Process

Part 1: We first look at “purpose” and “people.”

By Peter J. Polack, MD, FACS

Some of you who follow this column may be at different stages of EMR implementation. But what about practices that still have not made the decision to move forward with EMR? We, as doctors, are trained to make snap assessments and decisions. That's good for solving medical problems but not so good for things like major technology decisions. So, before you sign that check or contract, let's look at a general overview of what you might expect and what you should consider.

I prefer to break the entire EMR implementation process into “The Five Ps” — purpose, people, planning, purchase and, finally, the plunge. In part 1, I'll discuss the importance of purpose and people.

1. Purpose

It is important to have a clear idea of what you expect from an EMR system: What are your goals for EMR? Why do you want EMR? For the financial incentives? To make your practice more efficient? Are you running out of space for your paper records?

What is your vision of an ideal EMR system? A completely wireless system with portable tablet computers? Or desktop systems in every exam room with high-resolution monitors?

What specific features will the EMR system need to have to meet these goals and align with your vision? As the doctor, you may not know all the right questions to ask when it comes to such things as integration with the practice management system, coding and billing, technical specifications, etc.

Having well-defined goals can help you avoid:

► Unrealistic expectations
► Inadequate customization of system
► Loss of productivity
► Ultimate abandonment of the system.

2. People

This is the most overlooked aspect of most major technology implementations — and one of the most common causes of project failure. Introduction of any new technology can have a significant effect on people In general, older staff members may be more resistant to new technologies and may require a longer learning curve. Younger staff members are more tech-savvy. Nevertheless, proper skills assessment and training is critical for everybody.

Let's review the key players in your EMR implementation project:

Physician champion(s): There should be a strong advocate of EMR, preferably a physician, to keep the project on track, provide leadership and act as liaison between other physicians and the EMR committee (as well as handling training of one's peers and dealing with resistant behavior).

IT Staff or Consultant: Don't rely on someone with limited computer skills to handle your EMR implementation. If your practice can't hire a full-time IT person, consider sharing someone with another practice or retaining an outside consultant, preferably someone with experience in EMR or computer technology implementations. This person should also be on the EMR committee.

EMR Committee: This is a group representing the different departments in your practice (administrative, IT, billing/coding, and clinical) that will be involved with both the implementation of the EMR system and its day-to-day use. OM

Next month in Part 2, I'll discuss Planning, Purchase and the Plunge.

Peter J. Polack, MD, FACS, is co-managing partner for Ocala Eye, a multisubspecialty ophthalmology practice located in Ocala, Fla. He is also founder of Emedikon, an online practice management resource for physicians and administrators.