The Path to Paperless

Your EMR Project Could Be Hijacked

Avoid loss of control by progressing through 10 critical steps.

By Peter J. Polack, MD, FACS

EMR projects get “hijacked” every day. Some get hijacked by vendors, some by consultants and, yes, some are even hijacked by the very doctors who invested in the project in the first place — an investment that was supposed to help them treat their patients, run their offices and collect their money.

Since the launch of Meaningful Use, several studies have shown that the percentage of EMR IT projects that have outright failed or underperformed is as high as 50%. And one of the root causes is the inability to recognize EMR project hijacking.

Avoid Exposure to Hijacking

When I was writing “Navigating the EMR Jungle — 10 Steps to Ensure a Proper EMR Rollout” (you can obtain an audio book version free at http://www.freeemrbook.com), I was not strictly focusing on the issue of hijacking. However, in reviewing my 10 steps listed below, it was fairly easy for me to determine how and where a practice can lose control of its EMR project if it skips steps or makes a less-than-complete evaluation at each step in the process.

First, let's quickly go over the 10 Steps that make up a thorough EMR evaluation and selection process:

1 – Decide You Need to Do Something
2 – Assess Your Needs
3 – Form an EMR Committee
4 – Involve the Doctors
5 – Create a Short List of Vendors
6 – Plan Your Implementation
7 – Organize a Training Schedule
8 – Run a Simulation Day
9 – Go Live!
10 – Assess Current Setup and Plan Next Steps

Don't Skip Steps

EMR projects first get hijacked during evaluation and selection. The risk lies in jumping to Step 5 without progressing through the previous four. EMR vendors and HIT consultants may love it when you start at Step 5, but this means you are probably unprepared for a robust and thorough evaluation process.

The EMR evaluation process requires more reflection than a checklist (often vendor supplied) of reports and menus, work flow names and core modules. Selection requires more than asking for a proposal. Some of the signs of an EMR evaluation in danger of being hijacked are lack of doctor alignment (“Don't worry, the docs will come around”), low levels of management commitment (“Don't bother me, that's an IT project”) and underappreciating change management or the effect on staff (“Don't worry, they'll get used to it”).
In order to avoid this, make sure to be thorough on the initial four steps:
Step 1: Decide You Need to Do Something. Why EMR? Why now? Are you doing if simply for the financial incentives? For improved productivity? Regardless of the reason, your entire team should be on the same page before proceeding.
Step 2: Assess Your Needs. Before you commit to running an EMR on wireless devices, you need to determine whether your office has the necessary infrastructure. And when it comes to your staff, they might not be ready for EMR if they lack basic computer skills.
Step 3: Form an EMR Committee. Make sure all key areas of your practice are well-represented. The “perfect” EMR may be a no-go if the billing department can't do its job.
Step 4: Involve the Doctors. It's important that you put a major focus on those who are less than enthusiastic about EMR.

By being thorough in going through the first four steps of the EMR evaluation process, you will have greatly reduced the chances of your project being hijacked at Step 5 or a later step in the process. OM

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.