How to select and deploy an Electronic Medical Record system

This blog entry is a brief summary of readings I have covered as part of my training in healthcare Informatics from the University of California, Davis and is sourced from this paper and this book

The medical practice has to be ready to adopt an EMR and most importantly to recognize that the medical practice is adopting a vision, not just a technology. A vision means the practice will offer better patient care, a more efficient office and improved financials.  The most important role in the implementation of an EMR is a ‘champion’. The role of this champion is to gain buy-in and trust from perhaps reluctant staff in the medical institution, since workflows and business processes will likely change. Users of the new system must have high psychological ownership of the new technology.

Steps in the implementation of an EMR

Information gathering

  • Collect information: Patient data, radiology and lab reports
  • Assess workflows: Appointment scheduling, events during and after a patient visit, unscheduled visits and questions etc
  • Financial impact: Beyond the initial cost of the software are costs for training, maintenance and upgrades.

Selection Phase

Subsequent to information gathering, the medical practice selects an EMR. A few choices: proprietary vendors such as EPIC, Cerner and Eclipsys or  OpenSource alternatives . Both require creating evaluation criteria and extensive RFI/RFP processes by a project steering committee. Furthermore members of the medical practice should visit other practices and view their EMR implementations.

Keys to success

  • People are key to the successful implementation of an EMR. Everyone, clinicians and yes patients, must be aware of the new system to gain buy-in.
  • Workflow will be redesigned
  • A good project plan: just like the rollout of any enterprise software system, a good project plan is required that that clarifies responsibilities, sets objectives, generates tasks, and provides tight control and feedback with ongoing problem solving.

Alternative solution to installing an EMR

Of course a simpler alternative would be to select a hosted SoftwareAsAService (SaaS) offering that requires no in-house software, servers, or expensitve technical support staff.  A SaaS solution that I like and have interacted with over the blogosphere is Practice Fusion. Contrarians might argue that a hosted service is a one-size-fits all solution that does not fit the current practices of a medical practice. I would counter that an in-house system will be expensive to modify to suit a medical practice’s needs.

Hosted or in-house, the medical institution must recognize that their workflows and practices will have to change if they wish to gain the undeniable benefits on an Electronic Medical Record.

Image below courtesy of HIMS Analytics


One thought on “How to select and deploy an Electronic Medical Record system

  1. I am a college student and we have been studying EMRs as of late and I couldn’t agree more with your statement “People are key to the successful implementation of an EMR”. I think the most critical key to the success if the attitude of the people involved.
    I love the graphic stage chart! Great piece.

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