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EHR is More than Software

Posted on July 12, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Far too often when we talk about EHR, we mostly only talk about the software side of an EHR implementation. Certainly selecting the right EHR software is the most important part of an EHR implementation. It will guide and direct many of the other EHR implementation decisions. However, once you’ve selected the right EHR software, you need to make sure and give plenty of attention to the hardware side of an EHR implementation as well. Many don’t and suffer the consequences.

Yes, I know that many clinics and even some hospitals sit back and rely on their EHR vendor to walk them through all their new technical hardware needs. This can work out really well since the EHR vendor knows which hardware will work best with their EHR software. Plus, many EHR vendors have partnered with hardware vendors to provide a really seamless service to their customers. For example, we recently posted to the EMR and EHR video website some HP videos with their EHR partners Greenway and Quest Diagnostics. In fact, at HIMSS I learned about the HP EHReadySM Program which focuses on the seamless EHR implementation experience between EHR software and hardware. I was amazed by the number of EHR partners HP had.

Other clinics have their own in house IT support that deal with all of their EHR hardware needs. In some cases, the doctors themselves act as their own IT support. Regardless of how you approach your EHR hardware, here are some things to consider when it comes to hardware during an EHR implementation:

Consult Other EHR Physician Users – One of the best ways to learn what hardware you need for your EHR is to ask existing users of that EHR. Don’t ask a clinic that’s been using that EHR for more than a year. They’re likely using older hardware you can’t buy anymore and have also forgotten what they bought. Instead ask your EHR vendor for a doctor who’s been using their EHR for about a year.

Existing Infrastructure – Any vendor worth their salt is going to want you to use your existing infrastructure as much as possible. If you just bought a brand new laptop, then there shouldn’t be a need to replace that in order to use the EHR. However, be very careful that you don’t take this too far. I know many clinics who have tried to skate by on old hardware and made their EHR implementation miserable. They finally spend the $500 on a new desktop and EHR satisfaction skyrockets. For some context on when to invest in hardware, read these article on EHR performance issues and EHR slowness. Make sure your lack of investment in hardware isn’t the reason your “EHR is Slow.”

Financing – Yes, the cost of EHR software has dropped dramatically with even a number of high quality Free EHR software offerings. However, many doctors forget to add in the EHR hardware costs including: desktops, laptops, scanners, tablets, printers, cables, network devices, signature pads, cameras, etc. You can and should defray these costs with existing infrastructure as mentioned above, but that only goes so far. All of these hardware costs can add up and especially larger clinics might need to consider financing the cost of all this hardware.

Lifecycle Management – If you’re in a larger clinic you’re going to want to make sure you have a good lifecycle management plan in place for your hardware. A thoughtful replacement cycle for your hardware is so much better than unplanned hardware crashes with no budget plan to replace it. This replacement cycle should also correspond to your EHR vendors ongoing development plans. How much longer will they support your current hardware? When will they support the latest operating system?

Hire Great IT Help – With few exceptions, the best thing a clinic can do is to hire competent IT people to assist them with the selection and implementation of their hardware. A few doctors get a kick out of the latest IT. For the rest of the doctors out there (which is most of you), find great IT support. No, your daughter’s boyfriend who likes computers usually doesn’t match that description.

Hardware Takes Time – When planning your EHR implementation schedule, make sure you give plenty of time to implement the hardware side of the EHR implementation. It takes time to select the hardware, for the hardware to be delivered, for the IT people to implement, configure, and test, the hardware, etc. I’ve seen many EHR implementations delayed while they’re waiting for the hardware to arrive.

Those are a few suggestions to help you out. I hope that readers will offer other suggestions in the comments. My key message for this post is to not forget about the hardware side of an EHR implementation. EHR hardware is completely manageable if you deal with it early. If you wait or skimp, then it can wreak havoc on your EHR plans.

This post is sponsored by HP Healthcare, however opinions on products and services expressed here are my own. Disclosure per FTC’s 16 CFR, Part 255.

101 Tips to Make Your EMR and EHR More Useful – EHR Tips 46-50

Posted on September 13, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Time for the next entry covering Shawn Riley’s list of 101 Tips to Make your EMR and EHR More Useful. I hope you’re enjoying the series.

50. Determine how complete the financial reporting is
Don’t assume they have the reports that you want because they have other doctors using their EHR. Have your practice manager or business person figure out the types of financial reports your office will need to run and make sure that your EHR vendor does them out of the box. If they have develop new reports for you, it either won’t ever get done or is likely to cost you a bunch of money.

49. Take a close look at financing your EHR vs. paying straight cash for it
I’ll leave most of this conversation to your accountant. Plus, the decision is quite different in a hospital vs ambulatory setting. In the ambulatory setting we’re seeing a big shift to purchases that don’t require a huge up front fee and/or a bunch of financing. I think this is a healthy change for the EMR industry and one that more doctors should embrace. Also, get a good lawyer that’s knowledgeable of EMR contracts before you pay too.

48. Plan for a rollout gap
The idea of a rollout gap refers to the loss of productivity which is almost certain to come with the rollout of an EHR. The key is to plan for this loss of productivity. Ask other doctors that have implemented that EMR how long it took them to get back to full productivity However, you can also do things to minimize the loss of productivity by having a well thought out implementation plan and good training.

47. Plan for staffing surges
This suggestion is more apt for a hospital environment. In that case, you’re likely going to need a lot more staff during a go live. in the ambulatory setting, you might have a consultant or two around to help. You’ll also want your IT support somewhere close by, but otherwise you won’t have the same surge of staff as a hospital EMR implementation.

46 Know where your charges flow
Don’t underestimate the change in how charges will be captured and reconciled during an EHR implementation. EHR’s often significantly change your charging process. Much of the workflow planning that I do for an EHR implementation is around entering, collecting and billing the various charges. You’d think it would be easier than it is, but it always seems to be more work than we realize.

If you want to see my analysis of the other 101 EMR and EHR tips, I’ll be updating this page with my 101 EMR and EHR tips analysis. So, click on that link to see the other EMR tips.