Sunday, May 8, 2011

Planning for an EMR implementation

CEOs and board members - those in charge - must have a coherent understanding of and commitment to an EMR project for it to go forward successfully.  Sometimes an upgrade to the database storage method is a required step to implement an EMR. 
An EMR can mean many things to many people, from customized workflow screens that simply show staff a “to do” list of activities and provide the ability to enter events and track their completion, all the way to a completely electronic record with all notes and records including scanned documents from other sources stored in an information system and digital signatures vetting all clinical notes and decisions.  Often providers have interest in a clinical workflow, “to do” list presented to clinicians as a “dashboard” screen.  That simple could be quite successful and add useful functionality for providers while utilizing the investment in current software and avoiding any sort of upgrade.
Implementation of this simpler version of an EMR takes planning on both the part of providers and the current software provider, not just for software modifications but also for work flow analysis; design; training; budgeting; purchasing additional equipment and supplies; installation of computer equipment; network capacity analysis and network infrastructure upgrades to handle additional simultaneous users.  Planning and preparing is essential so that providers have the ability to make use of the new functionality.
A project plan for implementation of any aspect of an EMR is necessary for the change being done in phases.  Those must be defined, with scope of work at each stage described and a time line and milestones identified.  Most importantly, the board of directors or governing body must review and approve any EMR plan.
Our experience is that the successful implementation of any additional functionality in the realm of an EMR hinges on a coherent, specific and agreed upon project plan that also includes accurate cost estimates and we can either assist in leading the process of developing a plan or consider bringing in outside resources to lead the project.  Either way, it is critical that administrators set the goals for an EMR and rely on functional users to make recommendations and to participate in the entire project.