Managing the Risks of EHRs
Sometimes you can’t put a price on value. Implementing an electronic health records (EHR) system is indeed a financial investment, but moving your organization forward into twenty-first century health information technology will bring in more than just monetary returns on investment.
The greatest reward is having the peace of mind that your patients and clients are receiving quality health care because you made the choice to switch from an outdated, error-ridden system to a more efficient electronic one.
The benefits are clear. But administrators and physicians alike still grapple with the decision to take the plunge. The risks may make it seem like a gamble, especially since the stakes are high. But through thorough research and planning, you’ll no doubt win big.
A LONG PROCESS
The problem: The selection and implementation of an EHR system can take months or even years.
The solution: Give each step the amount of time it warrants, and remember that the key to success is careful planning.
To begin this daunting task, map out a timeline that details your organization’s goals and due dates. It is important to come up with realistic objectives. Then, choose a vendor that is committed to your needs. Together, you can develop a plan that will ensure your organization achieves its goals and is equipped with the tools it needs to thrive in a new, paperless era.
The American Medical Association offers a helpful resource of checklists and suggestions for those hoping to implement EHR in their facility. Also, with increased media attention on the EHR section of the American Recovery and Reinvestment Act (ARRA), there is a plethora of information available on the subject.
The length of time is takes to train the staff is also an issue. But you’ve waited this long to take the plunge into new technology, so what’s the hurry? In Health Management Technology, physician Owen R. O’Neil describes the success of implementing an EHR in his four-location orthopaedic practice. (See the article here) His practice chose to complete training in two phases, so that half the doctors could continue serving patients while the other half mastered the new technology. This model may not be feasible for your organization, but keep in mind there are different ways to accomplish the same goal.
The process of implementation and training may seem long. In the end, though, you’re not just changing how you keep records; you’re changing how you do healthcare.
A PRETTY PRICETAG
The problem: Depending on the size and nature of your organization, EHR systems can cost up to hundreds of thousands of dollars.
The solution: Don’t let the price discourage you from making an improvement; there is grant money available.
As part of ARRA, the federal government has promised billions of dollars in financial incentives through the Medicare program to encourage physicians and hospitals to adopt an EHR system in a meaningful way. The Department of Health and Human Services reported that over a five-year period, the government will provide financial incentives to as many as 1,200 physician practices that use certified EHRs to improve quality.
Translation: There is (or soon will be) money out there. And your organization has a good chance of accessing some of these funds now more than ever.
This doesn’t just go for hospitals and physician’s offices, and you don’t just have to look to the government for aid. An article by HealthLeaders Media notes that private foundations and corporations dole out money for community health centers, and it takes a savvy manager who knows who and how to ask. It also recommends checking out the Foundation Center, a national nonprofit service organization formed to connect nonprofits with grant makers.
You will need to do some homework while you shop. After narrowing down your list of possible vendors, see how they stack up against one another. Don’t forget to look at value as well as price. Ask other hospitals or organizations like your own that use the software for references.
Like many investments, it may take up to two or three years for your hospital or organization to break even. But until actual money starts rolling back in, don’t forget about the intangible returns on investment: improved patient care, trust, quality, less mistakes, and more time spent on providing quality care than filing papers.
LACK OF STAFF SUPPORT
The problem: Not everyone on staff is on board with the decision to switch, and some don’t want to learn the new system.
The solution: It may be difficult to convert certain employees, so emphasize that this change is not only necessary but will indeed be a good thing.
Some people in your organization will balk at the decision to implement EHRs, claiming their current way of doing things is sufficient and a new system costs way too much. This is why it is important to have a designated project manager and a champion of the cause. While your organization needs to assemble a few key players into a taskforce to take on this endeavor, it is still a team effort. Getting everyone on the same page will require perseverance and focus on change management (click here for the full EHR Institute article).
Additionally, most EHR vendors will have consultants ready to train and work with your staff, and some have hotlines and help desks set up to provide technical support. Explain to your staff that they will not be left stranded in this process and that there are plenty of resources to help them.
FAILURE TO LAUNCH
The problem: As many as 50 percent of complex software implementations fail.
The solution: It all comes back to planning.
If it is not already clear, remember: Failure to plan is planning to fail. The entire process incorporates so many different aspects that it is impossible to delve into it without first developing a systematic approach.
One important decision you will have to make is how the system will be rolled out. Different organizations – depending on size, number of locations, and other variables – have the choice of three main options.
1. Pilot: This method lends itself to organizations with more than one site and allows an EHR system to be tested in one location. The guinea pigs can work out the kinks and teach others how to use EHRs.
2. Phased: Like Dr. O’Neil at his orthopaedic practice, organizations can choose the phased method by training a small group of individuals at a time. This may help the workflow run more smoothly as people learn how to navigate the new system.
3. All at Once: Others may opt to teach everyone at once. Especially at smaller centers, this method allows the entire organization to work through the new system together.
By now, it should be clear that EHR implementation is a big deal. It is an investment of both financial and human resources, and the decisions you make now can impact your agency or practice years down the line. It is critical to do as much research as possible to ensure that your organization manages the risks of implementation properly. In the end, despite the pitfalls, your staff members will find themselves strengthened by the decision to go paperless.