Ten Tips for Converting Paper Records to Electronic

Good planning and staff buy-in are keys to success.

By Ophthalmology Management staff

One of the major tasks that accompanies the transition from paper medical records to electronic is the conversion of paper charts to a digital format. This process, often involving tens of thousands of patient records, can be viewed as a tedious, time-consuming chore.

However, with some thoughtful advance planning, you can choose to embrace chart conversion as a significant opportunity. As you go through the conversion process, you can eliminate numerous inactive records, build staff cohesion, tailor templates so that they accurately reflect doctors’ and staff's real needs, and enhance both practice efficiency and the patient experience by creating a high-functioning and streamlined EHR system.

Following are ten brief tips to make your conversion from paper to digital records a success.

1. Get started early. Once you have made the commitment to convert to electronic records (and even before choosing a vendor), begin systematically reviewing your paper charts and records to cull patients that are no longer active in the practice. Every paper record that can be eliminated means time saved in the conversion process.
2. See how others have made the conversion. If you are in the process of vendor selection, make sure you perform a site visit to one of your top candidates’ existing clients. Visit a practice similar to you in size and scope to see how the EHR functions in their environment. This has many benefits, not the least of which is to give you ideas for how to structure your EHR and convert your paper to digital records. Ask the practice how they did it and pull from that experience helpful tips that your practice could follow.
3. Have a transition plan. One of the biggest challenges of an EHR implementation is deciding what information will migrate to the new system and determining how it will be transferred. The plan for this transition must be decided early in the process. In general, most vendors do not encourage paper-based practices to try to enter all information into the new system before the system goes live.

Those practices that enter patient data manually may choose to input a portion of it, such as recent progress notes, before the system goes live. Others choose to handle all of the data entry as patients come in for office visits. Many practices have found that manually entering problem lists, medications, allergies and recent labs for all active patients initially helps to speed the process at the next office visit. Practices that wait to enter data should be prepared to add a few minutes to each patient appointment to accommodate the extra time it will take to enter existing patient data.

Besides entering data manually into the new EHR, data can also be extracted from an existing source. For example, if progress notes or transcription files are available in an electronic form, such as a word processing program, the vendor may be able to save these files in a format that would be compatible with the new EHR system. In addition, any interfaces that are built between the EHR and the practice's billing or practice management system will automatically populate the EHR with patient data, such as demographic information.

4. Obtain staff buy-in from the start. Every conversion to electronic records needs “champions” who generate enthusiasm for the transition and are able to articulate the benefits of the switch. Holding informal staff meetings early in the process and explaining specifically how efficiency and workflow will be improved by going electronic helps bring staff members on board. It won't hurt to have pizza or snacks at these meetings to emphasize that the practice is embarking on a positive path.

To help you get full clinician buy-in for the EHR system, make sure your doctors are represented on the implementation committee. It will help build trust and bridge the gap for physicians who rely so heavily on paper charts. Giving them a voice every step of the way will help see them through the transition.

5. Get input from everyone on the staff. Everyone has ideas on how their jobs can be made easier and more rewarding. Encourage all staff members to contribute their best ideas. This is also a good way to find out which staff members may be reluctant to make the transition to electronic records. Those who resist change will probably require a little more personal attention to convince them of the value of the change.
6. Tailor the templates. Ophthalmology-specific EHR systems come with templates used for entering data for examinations and common ophthalmic procedures. As part of planning, start with the vendors’ basic templates and have staff members review them to determine how the templates can be customized to meet the specific needs of your practice.
7. Practice with the new templates. Get the staff together and run some hypothetical patient encounters to determine if these templates will be suitable for real-world interactions. If glitches arise, there is still time to make changes before the practice goes “live” with the new electronic system.
8. Work with the vendor's “point person.” Your vendor should make available a person who can serve as a liaison between the practice and the vendor. It is important that this person is highly knowledgeable, committed to your success and personally compatible with your staff and practice culture.
9. Work with the holdouts. There will always be staff who initially resist change. This does not mean they are lazy or disloyal. It only means that they need a bit of convincing and encouragement. In most practices, everyone will get on board when they can see the real benefits of going electronic.
10. Stay focused on your goals. Going “live” isn't the time to relax. You will continue to need strong vendor support and the staff will need to remain focused on the ultimate goals and benefits of this major change in the practice. Make every effort to reinforce the behaviors that lead to success with electronic records. Complacency is the enemy of success, so make sure that the staff continues to work to derive the full benefits that an EMR system is capable of delivering. OM