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How To Create Satisfied EMR Users

Posted on September 3, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

These days, we’re deluged with statistics on medical practices determined to show their EMR the door — but I’d like to believe that it’s possible for doctors and EMRs to have a happy marriage.

A few months ago, on question-and-answer site called Quora.com, a health IT expert named Mark Olschesky posted a nice list of factors which he believes are critical to a successful EMR/practice relationship. I thought they were worth sharing:

Doctors, clinic staff and administrators agree on business metrics and functions they want to improve with the EMR.

Some examples proposed by Olschesky:

· Right now I need to do manual chart reviews for research and I have to hire 3 staff to help me with this. I’d like to build forms so that I can do this automatically.
· It takes us 7 days to send follow-up communication to referring doctors. Can we speed this up to one day?
· I’d like to prove that I do a comprehensive visit so I can bill the proper amount of money for a visit.
· We would like to know every child that has a difficult airway and fire a warning every time we access their chart in the hospital so that everyone knows they need to prepare for a tricky intubation. This can save lives. 
· I do the same thing 50 times a day and I don’t want to do that anymore. Can you standardize the way that I do x thing 50 times a day?

The tech contact person needs to meet with clinicians regularly and get their feedback on what they want. 

Rather than simply coding up new features or tools, the  IT person needs to have clinicians check out the tools they are building before they go live with them in the system, he says. Some practices are loathe to take the time it takes to slowly and carefully build out, but they should grit their teeth and do it anyway. “It pays out at a major multiplier,”  Olschesky notes.

Practice leaders need to be absolutely clear about which organization-wide decisions are being made and how that plays out in how the system will be configured.

Rather than simply unveiling the system at go-live time, there should be an easy channel for clinicians to submit feedback and share what changes they think will be helpful to them, Olschesky says. Otherwise, groups may end up with doctors who are needlessly unhappy. While some unpleasant or unpopular features may still be necessary, due, say to regulatory requirements, none of these features should come as a surprise to users.

Practices should make sure that *plenty* of training opportunities are offered. 

Everyone in the practice should get enough training, specialized to their function, and everyone should be able to practice before the software is turned on. And everyone in the practice should give the system a test run with simulated  patients before go-live, he advises. Why? Well, aside from the obvious need to be oriented, there’s no such thing as a no-brainer EMR, he says. “This might make some UI/UX people cringe, but I’m going to say it: We can’t design an EMR solution that is totally obvious and requires no training and no practice,” he argues.

Getting the core EMR workflow to a level that’s comfortable to physicians is obviously of tremendous importance. But it’s not just a matter of getting physicians to a point where they can function. Practices will never be able to leverage the EMR to take care to the next level if they’re struggling to cope with the basics — and that’d be a real shame.

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.