EHR

Helping your practice’s effort in Implementing EHR

Get the whole team on board to ease the switch to electronic records.

By Shawn Menke, Topeka, Kan.

The incentive payouts for the electronic health record (EHR) incentive program within the American Recovery and Reinvestment Act of 2009 are already beginning to dwindle. Eligible professionals had to demonstrate meaningful use by 2012 to receive the maximum payout, with lesser amounts available each subsequent year until 2015. After 2015, eligible professionals will be penalized for not providing meaningful use.

If you have yet to adopt EHR, you’re not alone. Our practice, Genstler Eye Center, in Kansas, had doubts too. Our team’s concerns ranged from: “It’s too expensive” to “it’s overwhelming” and “it’s not going to make us provide better care or our practice more efficient.”

However, we started seeing benefits sooner than we expected. This article reviews how we brought everyone on board with EHR implementation and improved our practice.

Maintaining a Positive Attitude

Initially, our impetus for implementing EHR was fear of penalties. However, after two years of researching and analyzing EHR vendors and visiting practices that had successfully implemented EHR, our purpose had changed. We soon started focusing on how to use EHR to make our practice more efficient, provide better care and make our jobs easier.

A positive attitude was key to our EHR implementation policy, starting with the physicians. Whether they are owners or not, physicians are the leaders of a practice. Employees often look to them to set the tone of the practice. If there is negativity about implementation at the top, it will inevitably filter down to everyone in the practice. On the other hand, if the physicians spin every obstacle into a learning opportunity and continue to encourage staff, EHR implementation will ultimately go well.

Identifying “Super Users”

Another important element of our plan was the designation of “super users.” One representative from each department (billing, front office, technicians, etc.) was selected to be part of a core committee. This group is responsible for representing their departments, brainstorming, analyzing software options and constantly providing feedback. Initially, these super users met weekly with a physician representative to provide input and make decisions. A year after our initial implementation, they still meet weekly to provide feedback and suggest tweaks to the system. This group also aims to keep everyone positive with the mantra: “every problem has a solution, every frustration can be addressed.” A fundamental change in operations will always bring bouts of negativity, but our super user committee has refused to let that attitude permeate.

Empowering the Staff

The third group in the office dynamic encompasses the remaining staff. We found the best way to keep the staff positive is to empower them. We invited those who were not chosen as “Super Users” to provide feedback, voice desires and suggest solutions to problems. We closed our office for two days of intensive training for our 30-person staff. The trainers from our chosen EHR provider, ManagementPlus, were excellent, and our staff picked up what they needed to learn right away. On the first day the EHR went live, friends and family came in on a reduced schedule for free exams. This created a relaxed environment where we felt free to make mistakes. At the end of the day, we summarized what we learned and any remaining questions. The second day, we maintained a reduced schedule, but with regular patients. By the third workday we were working at full strength.

Looking Forward

Our persistent, positive attitude is not pretentious. Our EHR system has brought a lot of great benefits. Our physicians especially appreciate having all of a patient’s previous visual tests and diagnostic data at their fingertips, in a format that makes it simple to analyze change over time. Previously, they would have to flip through paper charts to locate intraocular pressure or visual acuity and compare it with current scores. Additionally, if they wanted to look at retinal changes, they would have to leave the patient in the chair and go to the OCT device to pull up the patient’s profile. Our doctors can now sit with the patient, review their progress over time, and easily share images with them. Visualization of these records is helpful in improving patient comprehension, satisfaction and compliance.

Creating Expectations

One year into implementation, I can confidently say that converting to EHR has been a success. However, it is important to set your expectations and adjust your perspective; one is never completely finished implementing EHR. We are always changing and building new templates as we find more efficient ways to achieve our goals. There will always be modifications to meaningful use requirements. We assigned one dedicated staffer to stay up to date on all regulatory changes via organizations and newsletters. We have a different person who follows clinical changes and integrates new equipment and other changes to improve patient flow. These two meet to review major modifications, ideas and keep the rest of the staff informed. This system has helped us to keep organized.

As with any technology, a practice has to decide if it is going to let technological advancements pass it by or if it is going to stay at the forefront of industry. Our practice has made a conscious effort to keep up with the times. There are many benefits to a well-designed and carefully implemented EHR system, both for the practice and for the patient. Keeping that in mind as an endgame will make the implementation process much easier. OP

Mr. Menke is the Administrator at Genstler Eye Center in Topeka, KS, which has served the greater Topeka and Manhattan communities since 1994.