Electronic Medical Records - Is Your Staff Ready?

One thing often forgotten in major projects such as an EMR implementation within a medical practice: the impact the change has on the staff. Do you think they're prepared for the significant change of moving from paper record-keeping to electronic? How much training will it take to get your employees using the system proficiently, and who needs to know what? The staff's perceptions and use of the system are key in the measure of overall effectiveness and success. It's important to put people first.

Most medical practices, and ophthalmologists in particular, have a majority of staff involved in data input using basic writing and typing skills. When converting your EPM to NextGen from Medical Manager, we went from a DOS keyboard-stroke data entry system to a mouse-driven, Windows-based menu. This may at first seem a minor difference, but it proved a somewhat stressful change for office staff who had enjoyed comfort with doing things in a specific way. After transitioning over to the new system files started disappearing mysteriously, and printouts were popping up at remote offices miles and miles away. It certainly took a bit of time to hone in on the system and how to use it properly.

When preparing our technical staff to implement the EMR module, we established a computer classroom for teaching computer basics. When transitioning over to our new EPM, we switched a few employees into the classroom at a time, there giving them a basic skill set assessment and a bit of training. There they had the chance to use their new skill set by calling up patients to verify their appointment time and information, then entering it into the database. This also helped to make the training time more valuable, as we were able to enter the data and confirm the upcoming schedule information.

When the training was completed, the staff person should have a basic understanding of Windows terminology, including: maximize, minimize, restore, task bar, start menu, tool bar. Because the EPM/EMR system doesn't exist in isolation, users should also understand basic computer skills including: media, drives, files, folders, defaults, paths, and logging out.

An EMR system has its own set of functions and terminology. Staff members will have to be able to tell the difference between images and active images, distinguish between templates, tell fields from data grids, and pop-ups and pick-lists. It's best when your employees have an interest and want to develop it. Some of the details of your staff members' aptitudes and experience can be determined in short assessment quizzes or interviews.

In addition, now is the time to put your security policy for computers and the EPM/EMR system into practice. What are the password requirements? With what frequency will they be updated? What security hardware will be used, if any? What are the consequences for violating policy? How long will an inactive computer remain idle before and automatic timed log-out? Who will maintain security policy? In this day of HIPAA regulations, maintaining EMR system security for patient data must be continually instilled into staff procedure for implementation.

Peter J. Polack, M.D., F.A.C.S., is founder of emedikon, a medical practice management consulting firm and president of Protodrone, a software development company specializing in medical practice applications. By the way, do you want to learn more about implementing EMR in your own practice? Download my free report "Getting Through The EMR Maze." Click here for the free EMR report

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Electronic Medical Records - Preparing Staff Members

In order to implement important changes at your practice, you must gain buy-in from the staff. The executive search firm Korn/Ferry International cites one of the most common management mistakes as the situation when a new executive tries to implement many new strategies and changes. If this executive fails to take the existing culture into consideration when they arrive, their initiatives often fail.

For example, consider the controlling manager who arrives at a business only to discover that the employees work collaboratively. This combination can lead to a significant struggle and obstacles. Alternately, let's consider the savvy executive who approaches the situation with an ability to acclimate, who discovers ways to work in harmony with the existing culture and style at the firm. The latter approach can significantly assist your efforts to gain cooperation from staff when implementing the change from paper records to electronic medical records.

Proper planning and the ability to adjust during the process are two tools that can help you avoid the need to drop an electronic medical records project. A cancellation usually equates to a large negative cost to a particular practice. The 'Change Management' process, one which touts navigating change in a careful and systematic way, is a great tool to employ during this time.

Adaptable Electronic Medical Records Systems : 10 Key Factors

1 - Be clear and concise in speaking to each individual. Everyone should understand what is happening and what is expected from each. As long as having confidence doesn't mean being unrealistic, it can be good for morale when problems arise. Be prepared to calm the fears of some staff.

2 - The need for a change will not go unquestioned. Present your case in a formal, referenced way which proves the benefits of changing over to a paperless system. Users need an incentive to change their habits, and won't actually use the new tool otherwise.

3 - Maintain good communications by keeping a dialogue channel open, encouraging participation at each step. The plan should also include a time line of actions for completion. Make sure to give the staff all the required information in the implementation process.

4 - Address the aspects of the culture with explicit intent and detail. People can be expected to learn new skills on a gradual basis, taking baby steps toward learning more about technology, including advanced systems such as EBM and EMR. Resistant doctors could cause delays.

5 - The presence of problems is a constant reality; expect the unexpected. These types of occurrences could push back the system go-live date, and the effects will reverberate throughout the organization. Use the correct degree of flexibility to manage these effects.

6 - When gaining acceptance, start at the top. The top tier of staff members, especially physicians and administrators, should be on board with the program, including any champions for the cause. If you have strong allies with the right technological skill and without a naive level of optimism, it could assist the entire campaign.

7 - Always acknowledge the human aspects. Without acceptance from the staff, a change to a new system could ultimately fail. The prospect of change often adds anxiety to the mix of human emotions, and this should be acknowledged during the process.

8 - People should get involved at every level, so that everyone feels they contributed to the outcome. A committee of staff members, formed to create a proposal for delivery to the physicians, is another excellent tool. This committee should be formed from those who will ultimately use the EMR: administrators, business staff, and medical assistants.

9 - Always make identifications and assessments of core values and beliefs in a cultural assessment, including possible sources of conflict or resistance. People often become set in their ways, resisting change as a general rule.

10 - The leaders of the group should take ownership over project elements. As these staff members have better credibility with their subordinates compared to the physicians, these people are crucial and should be first trained in the new system, then passing the info on through training.

Peter J. Polack, M.D., F.A.C.S., is founder of emedikon, a medical practice management consulting firm and president of Protodrone, a software development company specializing in medical practice applications. By the way, do you want to learn more about implementing EMR in your own practice? Download my free report "Getting Through The EMR Maze." Click here for the free EMR report

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