Adoption of Electronic Health Records is a major topic of discussion for many healthcare organizations. Transitioning from paper to an electronic health system requires through planning, research and consideration. This paper will different components that had to be considered when transitioning from paperless to electronic health records.
Salem Women’s Health is currently only using administrative information health computer systems to keep information used in the practices daily operations. The advantages of using administrative information health computer systems is that is allows the practice to evaluate, measure and improve the quality and efficiency of its operations. However, since it doesn’t involve operation that have a direct link to patient care, it does not provide support to the care of patients. Nor does it have an impact on improving quality patient care.
Salem Women’s Health handles all billing procedures in-house. Over the course of one year the practice transitioned to electronic coding and billing, claim submission, and reimbursement. They have been going strong with these electronic processes for four years. Although the practice was reluctant to change from the paper process they are so familiar with, the benefits of transition to electronic health records will be worthwhile. Some benefits include, such less errors, increased reimbursement quicker turnaround time for claim processing, and improved staff efficiency to name a few.
Systems Considered
Financing an electronic health system is one of the most important decisions a healthcare organization will make. Electronic health records computer selection can be an intense part of the transition process as there are many systems to choose from, and you want to ensure that system is the best fit for your organization. MediTouch EMR, Athena Clinicals, Epic Care EMR, Kareo EHR, CureMD EHR, Practice Fusion were some potential computer systems that we considered for Salem Women’s Health when researching the different vendors. However, we wanted to make sure that the system we select includes key capabilities such as health information and data, result management, order management, decision support, electronic communication and connectivity, patient support, administrative processes, and reporting and reporting and population health. (Key Capabilities of an Electronic Health Record System, 2003). We decided to discard MediTouch EMR, Athena Clinicals and CureMeD EHR because they were cloud-based systems and we were looking for web based. EpicCare and Practice Fusion were discarded because the system did not have all the features we were looking for. We decided to select Kareo because it had all the features we were looking for in an EHR system. We also found that it was more budget friendly, as cost played a factor in the selection.
Funding
There are several ways in which implementing electronic health records can be funded. Some funding options considered include leasing, Medicare and Medicaid incentives, grants, loans, vendor deferred payment plans, and cost sharing and group payment plans (US Department of Health and Human Services, n.d.) Before Salem Women’s Health decided on the funding options we would take advantage of, we assessed the practices cash flow, credit and whether or not we could get a loan if needed. We also established a budget for implementation that includes initial costs and cost of labor. Salem Women’s Health decided that leasing was a better fit for the practice because it would give more flexibility with the payment option, and is more cost effective as it does not require large upfront cost. It would allow the practice to finance the whole purchase, which would include any hardware, software, training and shipping cost. (What are my Financing Options? n.d.) Additionally, outdated software/hardware upgrades without having make a complete purchase all over again.
EHR Transition Team
Staff members that would be involved in the EHR transition include physicians, nurses, receptionists, medical assistants, compliance office staff and administrative staff. There will also be a lead physicians, project manager, and lead super user. The lead physician that will lead the practice throughout the implementation process and serve as a liaison between front line uses and technical and administrative staff.
The project manager will work with the vendor and all practice staff to keep stakeholders focused on their timelines, track progress and manage day to day issues. The lead super user will serve as the in house expert for the new EHR with configuring the HER software, creating templates and order sets, and developing revised workflows to address issues that front line users identify. (Hodgkins, 2015)
Process Changes
With the implementation of EHR, processes such as prescribing, appointment scheduling, laboratory orders, referral generation and management, clinical Documentation will be changed. These processes will be done electronically. There no longer be prescription pad, paper lab orders or paper records. The Lead Super User/Super Users will be responsible to develop a plan for the new processes as well as train the physicians and staff. The super users will train the physician and staff through Incremental process. This will allow them to learn certain parts of the new systems gradually before learning something new.
Stakeholders
Stakes holders that will have a role in the EHR transition include the medical director, medical staffing director, chair OBGYN department, and physicians. Their role will be to provide input early in the process hence, allowing their concerns to be addressed and their needs to be integrated in the EHR. Once the new HER system is implemented the stakeholders will be responsible for continuously monitoring the system for efficiency, and care outcomes, as well as the workflow so that any system modifications can be made as necessary.
Some of the physicians have been resistant to accept the implementing of EHR for fear that the new systems will not provide direct benefits to their users and the process of implantation itself will change the traditional practices of the clinical environment. (Farukhi, n.d.) To combat this resistance we have allowed the physician to be involved in the pre-implementation phase allowing them to tailor the system to meet the needs of the practice. We have successfully gained buy-in from the physicians and staff.
Challenges and Opportunities
Lack of adequate electronic data exchange between the EMR and other clinical data systems (such as lab, radiology, and referral systems) are some foreseen barriers for the practice. Also, we foresee that there could be challenges such as difficulty with technology, lack of support, financial incentives and the time needed for the staff to learn the new systems. However, we anticipate the opportunities that the transition to EHR will provide. Some of the opportunities are secure storage and retrieval, reducing erroneous diagnosis, reducing incorrect prescriptions and unnecessary doctor visits, and reduced healthcare cost.
Conclusion
Transitioning electronic health records is a major investment that also required a lot of time. Healthcare organizations must be careful not to rush the planning and research phase of the process because there are many factors to consider. It is significate time to determine what system fits your organization best as this system will bring about changes to the business and clinical processes.
- Brooks, R., & Grotz, C. (2010). Implementation Of Electronic Medical Records: How Healthcare Providers Are Managing The Challenges Of Going Digital. Journal Of Business & Economics Research, 8(6), 73-84.
- Farukhi, F. (n.d.) Clinical Decision Support Systems. Retrieved from http://www.cwru.edu/med/epidbio/mphp439/Clinical_Decision.htm
- Hodgkins, M. (2015). Electronic Health Records Implementation. Retrieved from https://www.stepsforward.org/modules/ehr-implementation#section-steps
- HealthIT.gov. (2014) How Much is This Going to Cost? Retrieved from https://www.healthit.gov/providers-professionals/faqs/how-much-going-cost-me
- US Department of Health and Human Services. (n.d.) How to Budget and Fund EHR Projects. Retrieved from http://www.hrsa.gov/healthit/toolbox/healthitimplementation/implementationtopics/planbudgetsecurefunding/planbudgetsecurefunding_6.html
- What are my Financing Options (2016)? Retrieved from http://www.hrsa.gov/healthit/toolbox/healthitimplementation/implementationtopics/planbudgetsecurefunding/planbudgetsecurefunding_6.html
