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Choosing The Right EMR: Know Your Vendor

The designers of the best EMR systems understand that they are serving the real needs of physicians. Some flashy ideas work. Others are just clutter. The best EMR software engineers enlist the input of physicians and health care professionals who know the problems that providers face on a day-to-day basis.

The smart thing to do is research the history of a vendor. How long has it been around, and is it stable and profitable? How many clients does it have, and is it growing? Will it be around to support you in the long run? Does it have other clients in your medical specialty who are in your area?

If a vendor has clients in your area, contact them to see what their experience has been.

The question of research and development is critical. Is a prospective vendor committed to developing better software? If you buy their EMR will it evolve to include new functions that are appearing on the market? How often does a vendor update and release new versions of its software?

Finally, are these updates part of your contract, or do you have to pay for them separately?

Find out and be wise.

Choosing The Right EMR: Research

So okay, you’ve done a little research. You know the basics of what you want. In 1901, the people selling Packards came up with the wonderful slogan, “Ask the man who owns one.” That’s good advice. But beyond that, you have to take that fancy new Packard out for a spin to see how it really feels. Some vendors will help you use their EMR for a couple of weeks to see how it works.

Some providers love their software and wouldn’t swap it for anything. Others are not so sanguine. They wish they’d spent more time checking things out. The Packard looked all shiny and fancy, but in the end Henry Ford’s classic Model A carried the day. Why? Because it did what it was supposed to at a fair price and it was easy to fix.

Don’t fall for slogans or a fancy brochure or a salesman flashing more teeth than Liberace. EMR is a competitive market. Many companies offer terrific software. EMR has yet to settle into a market where three or four huge vendors push everybody else out of business in the manner of Chevrolet, Ford, and Chrysler. Now we're seeing what happen to the automobile giants who don't remain creative and flexible.

Ask around. Do some research on the internet. Best of all, talk to the providers who already have a system (the guy who has been driving a Packard). Visit their offices. A good EMR should be user friendly, and it should be easy to change the templates to suit your needs and tastes.

That’s not a bad drive around the block.

2n1 Integrated PM-EMR

Some practices that have long had practice management (PM) systems are now faced with the need to add electronic medical records (EMR). Is it possible to buy an EMR that will interface with your current PM system? The answer is usually yes, although some systems are not compatible. The thinking usually is that it will save you money by not having to buy new PM software, and it will reduce the training needed to learn a new system.

But you need to remember this: programming an interface between existing PM software and a separate EMR system can be complicated, and it’s hard to avoid glitches. If you work with two separate vendors, you have to rely on different levels of support, kinds of contracts, and separate sets of personalities.

An integrated system, in which all elements are programmed to work together, is by far the best choice for a number of reasons:

If you enter data into a PM database, it is immediately available to EMR and the other way around. A shared database gives you a seamless exchange of information on files, forms, and charts.

While EMR is great, PM remains at the heart of the practice. No cash flow, no practice. So you need to make sure that the vendor moved from practice management to EMR, a newer concept. If they were not both designed to work together, you’re facing increased opportunities for glitches. So look for a vendor that took it one step at a time, PM then integrated PM and EMR.

A single vendor can give you a single source for technical support and enhancements.

Planning for EMR Transition

One of the most important things that you can do when you install an EMR is to make sure that you plan for the transition from paper and that your physicians and staff are well trained. While a good EMR will do everything the vendor promised, it’s more complicated than having a techie show up one morning to install software in your computers.

And it’s not as easy for your staff as booting up one morning and tapping an entry key. To avoid confusion and frustration, you and your staff need to know what they face. The more you know, the more confident you’ll be in your ability to make the transition with a minimum of delay, confusion, and hurt feelings.

How do you do that?

You start by having key members of your staff and a representative from your vendor write a single-page schedule of what you need to do and when, plus who is responsible for each task.

You also need to identify the person or persons in your office who are best suited to manage the transition. There will inevitably be problems, but with good planning those will be kept to a minimum.

If your staff looks at installing EMR as an awful chore then it might well be a self-fulfilling prophesy. Do your best to interest people who are truly interested in EMR and give them some authority and autonomy. Also hold them responsible.

Embracing The Change - Papers to EMR

One of the big questions that plague physician’s offices considering EMR is what to do about older doctors and staffers who resist it. They’re comfortable with paper. They don’t like the idea of change. And they have convinced themselves that learning to use computers is difficult.

There are several things you can do:

You can automate the check-in drill at the front desk. A nurse, reception staff or even a patient can fill out the data you need to create a temporary paper chart for the reluctant doctors. You’ll have to scan the summary pages - active medications and a summary of the previous three or four visits - plus the notes the doctor made along with any followups. You can even bar code those notes to help you scan them into EMR. Give wary doctors something close to the documents they’re currently using.

You can give them a digital pen that they can use to write onto a screen so their handwritten notes are beamed directly into the patient’s chart. The trick is to start slowly, trying not to make major changes in their accustomed routine. After a few months, as their confidence grows, they’ll do more things digitally. They’ll know it’s not impossible for them to understand; it makes life easier, not harder. You can also hire scribes to help them out.