The Heart and Soul of Moving to an Electronic Medical Records System

The heart and soul of a successful electronic medical records (EMR) implementation absolutely lies with your staff. At Ironwood OB/GYN, Alice M. Halscheid, practice administrator, lead and managed a successful EMR system implementation. So what did it take to get there?

Preparation. Going to an EMR solution should not be a rash decision. After 3 years of research, watching the main stream EMR service providers, closely examining cost and extent of training, as well as making inquiries of other OB/GYN offices nationwide, Ironwood justified an EMR solution investment. Realizing the initial investment should be recovered via reimbursement through a more efficient means of billing, which helped to support the foundation of the investment.

Team Leaders and Communications. The physicians (providers) and practice administrator had many, many conversations about the transition from paper to paperless. The paradigm shift would present a steep learning curve, but the providers knew that in order to improve patient flow, treatment and care, they needed to make the investment. That commitment set the communications tone in the office.

• EMR systems were a focal point of discussion at staff retreats, monthly meetings, and so on. Staff and providers were encouraged to communicate via email. Providers were also encouraged to get on their computers every day to stay connected with the “EMR movement” by reading their emails.

• The physicians decided among themselves who would be the "champion physician(s)" for visiting other OB/GYN offices to see and ask how they implemented and used their software.

• Certain service providers and physician communications improved, based on the flow of the visit, or Treatment Plans because each physician had their own way of seeing patients -- breast examinations, paps, blood testing, questions and answers based on the patient's history. The treatment plans drive the entire EMR program, allowing for total documentation.

Assessment & Analysis. Ironwood concentrated on those software programs that seemed to be the most popular. It was time consuming, but very necessary. They needed to make sure the assessment was inclusive, not exclusionary. Office visits to the medical practices that used those programs followed.

• Seeing those programs that provide for the ACOG format for seeing OB patients and capturing the flow needed to accommodate seeing a patient for up to 8 months of pregnancy was a key requirement. From there, that service provider was again to the Ironwood office, which was a 3rd visit.

• Program selection was narrowed to three main systems that staff and providers believed to be quite functional for a OB/GYN specialty. While many EMR solutions are feature rich and functional, many were not a good fit for the OB/GYN patient flow.

• Due diligence included financial stability, system dependability, cost factors, training presentations, and validity of statements made by the company.

• It is known and expected that there is no guarantee that any one company will really be better than another. However, Ironwood needed to rely on its own sense and sensibility when making such a large purchase.

Implementation. The conversion effort to digital records was relatively easy. Staff and providers had to change some plans as Ironwood moved forward, realizing that the initial plan was not as effective as it could have been, but overall the transition has been relatively easy.

The practice has begun to scan entire charts into the system, which will enable the physicians to review a patient's chart from the convenience of their home. They no longer spend hours looking for lost charts through the office. Believe it or not, medical records positions are becoming obsolete, giving way to a leaner more efficient staff.

Faster and Sooner
Ironwood would have gone to an EMR system much sooner! It is amazing how efficient it is. There are still are some behavioral stumbling blocks however, in that, it takes the physicians sometimes a little longer to complete a patient’s chart because the software asks so many questions; it does not permit the "skipping" over some of the important information. No question about what it does – the system encourages efficient patient care.