Sarah Le Goff, CEO of Eye Specialty Group in Memphis, Tenn., recalls the day she realized the group’s outdated electronic health record system (EHR) needed to be replaced. It was July of 2022, and as the company’s new operations director she was meeting with department managers across the five-location practice to hear their top grievances.
“Every single person listed the EHR as one of their biggest issues,” Ms. Le Goff says, describing how the decade-old system had become a “tedious maze” of add-on programs, screens, logins and passwords. “Some tasks required 20 clicks just to get from a patient’s complaint to a review of systems.”
Over the course of 14 months, Ms. Le Goff and her team dedicated themselves to the monumental task of replacing their EHR. In return for their efforts, they now boast a system that not only eases health record management but also combines practice management and patient engagement capabilities into one platform.
Like Eye Specialty Group, you may be considering replacing your current EHR. Make no mistake: It is one big, fat, complex endeavor. The thought alone can be enough to make you put it off until the pain of staying the same overcomes the pain of making the change. The good news is that by developing and following a well-thought-out plan today, you could be trading in your EHR for a younger, faster and more efficient model by the end of 2025.
Know When to Say “When”
Ryan Montalvo, senior solutions engineer at EHR vendor Nextech, says a key first step is knowing when to take the leap. As Ms. Le Goff alluded to, Mr. Montalvo says staff frustration is one of the earliest and most obvious symptoms of an EHR in need of replacement.
“If you’re getting frequent complaints about usability or slow system performance, or having difficulty integrating your EHR with newer diagnostic devices, those are signs it may be time to consider replacing your EHR,” he says. “Inefficient systems may lead to mistakes in charting, billing or prescription processes, affecting care quality. They can also lead to lower staff morale due to frustration with slow or outdated systems.”
Other red flags include failure to meet compliance regulations, reporting needs or updated data security protocols, as are rising costs to maintain or troubleshoot the existing system, Mr. Montalvo adds.
Create a Transition Team
Once the decision is made to move forward, the first step toward replacing an EHR should be to gather a team of administrators, physicians and support staff to plan and carry out the process. Their tasks will range from setting timelines and budgets to selecting and onboarding the new platform. The team should choose a leader to serve as the central point of contact between its members and the vendor that is ultimately chosen to supply the EHR, says Michael Rivers, MD, senior director of ophthalmology at EHR vendor ModMed.
“It’s very important from the beginning to have someone to own that change management, to own the project,” says Dr. Rivers. “Often it’s the practice manager, but they’re usually not the right person because they’re already too busy.”
Instead, he advises appointing a well-organized staff member who can devote their full attention to the project. In Eye Specialty Group’s case, Ms. Le Goff served as team lead, pulling together key members from operations and administration.
“The operations team knows what the techs and the doctors in clinic need because they hear it all day, every day,” she says. “The admin team [can look] at billing, purchasing and inventory, MIPS and compliance.”
As for setting budgets and timelines, there is no one-size-fits-all approach as practices vary widely in size and staff, says Matthew Brink, MD, a glaucoma specialist who runs a small solo practice with five support staff in Palm Beach Gardens, Fla.
“My best advice is, no matter how accurate you think your estimate is, it will probably take longer and be more expensive than you think,” says Dr. Brink. “Have projected goals and timelines but be flexible and patient.”
Integration Is Key
The next priority is to identify a platform that aligns with the needs of your practice. Mr. Montalvo recommends seeking an EHR with templates for common conditions and procedures; the ability to integrate seamlessly with diagnostic equipment, such as ocular coherence tomography; strong data security; ease of accessibility; and built-in patient engagement and regulatory compliance capabilities.
Dr. Rivers agrees. “The best EHR software takes an integrated approach across all those areas,” he notes.
Ms. Le Goff says her team needed an EHR that could satisfy five major criteria: ease of use; data transparency to set and measure performance metrics; the ability to integrate with new and legacy devices; little to no need for third-party modules (eg, separate scheduling software); and robust vendor support. They ultimately narrowed their list to three vendor finalists, who were invited to pitch their platforms in detail.
“We had each of them come in on a different day and follow a preset agenda that was the same for each platform,” she says. Eye Specialty Group’s six owner-partners ultimately selected a cloud-based EHR that checked all of the team’s boxes.
Expect a Bumpy Ride
Once you’ve selected the new platform and signed the contracts, it’s time for the hard part: transitioning from the old EHR to the new one. Change management skills are vital to a smooth process, particularly where staff are concerned, says Dr. Brink.
“It is admittedly very difficult to implement change. People get used to the quirks of any given system, and there is massive inertia against change,” he says. Physicians, especially, can have a hard time.
“The physicians account for 5 percent of touching the chart while a patient is in the office, but 95 percent of the work with electronic health records is done by the practice managers, the schedulers and the billers,” says Dr. Rivers. “It’s important to help the physicians understand the value of the project for the entire patient journey.”
For her part, Ms. Le Goff says, “We did everything in our power to make [the transition] more of a fun experience rather than a headache.” Employees chose a carnival theme for the project. Each department was assigned a team name, and all five practice locations competed within and against each other for prizes.
“For example, training. The first person in every department to finish training on a given task [won] a prize. We had a portable speaker system. We had a mini projector for your smartphone. We had a cordless charger station for multiple devices. Things like that,” she says. Vendor representatives also got in on the act by bringing in popcorn, nachos and other food for on-site training sessions.
Bumps in the road are virtually inevitable, but they can be minimized by transitioning in phases, Montalvo says. Some might not be as insurmountable as they first appear.
Eye Specialty Group hit a rather large bump when its IT infrastructure wasn’t fully upgraded in time to go live with the new EHR, says Ms. Le Goff, but the IT department stepped up with a temporary Wi-Fi station that provided enough bandwidth to handle the platform.
“They came in over the weekend to make sure that they got done as much as possible. They worked after hours to get all that up and going,” she says. As a result, their transition, begun in February 2023, went live that September.
Dr. Brink advises keeping expectations reasonable even after the transition is complete, as kinks might still need to be worked out. He says it’s normal to feel “completely paralyzed” by a new system.
“But once you spend a good few days being less efficient than you would like, you will be surprised that the ‘newbie paralysis’ is short-lived,” he says. “Don’t let anyone catastrophize frustrating hiccups.”
It’s Not You, It’s Your EHR
Replacing an EHR system isn’t just about upgrading technology; it’s about enhancing a practice’s overall performance. A more efficient EHR can reduce administrative burden, improve patient record accessibility and enhance communication between providers and patients. The results are better patient outcomes, higher satisfaction and a more streamlined practice environment.
With careful planning and teamwork, your ophthalmology practice can confidently navigate the complexities and ensure a transition that maximizes long-term benefits.
“If your EHR isn’t helping to make your job easier and more efficient, be honest with yourself — it could be time to make the change. Don’t let inertia hold you back,” concludes Dr. Brink. OM
