An EHR Implementation Checklist

When implementing an electronic health records (electronic medical records) system, you will need to perform the following tasks. Adapted from "EHR Implementation in Ambulatory Care," a 2007 white paper from the Healthcare Information and Management Systems Society, this list is intended to give practices a better idea of how to allocate staff and whether you'll need to hire a project manager when implementing an electronic medical records (EMR) software system.

1. Develop an implementation plan. Establish the plan, which might include having the most computer-savvy physicians "go live" until the EHR's idiosyncrasies are identified and resolved, and then adding the remaining physicians.

2. Develop a scanning and abstraction policy. Convert paper records to electronic format. This might include having physicians review charts and select files important to patient care for scanning into the EMR.

3. Analyze workflow. With input from the practice's whole staff and help from the vendor, map how the practice's work will flow using electronic records. Use the study to train the entire practice.

4. Facilitate third-party interfaces. Set up the EMR system to communicate with several devices and entities, including: labs, hospitals and pharmacies; picture archiving and communication systems; diagnostic devices; and practice management systems. Consider paving the way for e-prescribing, patient e-mail and patient portal access.

5. Develop templates. Get input from all physicians on the template for physician note entry. Typically, these "electronic charts" are modified vendor templates or are designed by the practice.

6. Conduct training. Develop training material for all existing and future staff. In a sample workflow system from HIMSS, medical assistants enter simple patient history and vitals directly into the electronic medical records software, and physicians enter data from a patient worksheet into exam-room EMR terminals.

The Importance of Change Management to EMR Implementation

What do the tasks of electronic medical records (EMR) implementation and the principles of change management have in common? Quite a bit, according to experts in the implementation of EMR software systems.

According to Harvard Business School professors Michael Beer and Nitin Nohria, PhD, 70% of all change initiatives fail. (Remember that installing an EMR system is essentially one large change initiative.) Beer and Nohria attribute this failure rate to the way in which organizations approach change. Their research indicates that organizations, based on their culture, choose an “either-or” approach. Some organizations choose an approach that tries to create a quick return on investment based on economics. Others approach change in an open, trusting culture based on results over time. While the professors recommend a blend of the approaches as most effective, some organizations do not consider change management strategies as part of the transition to the electronic medical record (EMR).

Moving to an EMR requires a change in employee attitudes and behaviors. Healthcare organizations that address change management issues and help their users prepare for the impact of an EMR may increase their odds of being part of the 30% who complete successful change initiatives.

Want to learn more about how change management influences EMR implementation? Read a more thorough discussion of this topic by clicking here. You'll give yourself the best chances for success.