May 25, 2016
Written by Adam C. Uzialko
One of the most precarious aspects of adopting a new electronic health records (EHR) system is the implementation phase. Not only is it time consuming, but it also comes with many potential pitfalls that could ensnare your medical practice and disrupt operations. That’s especially detrimental in the health care world, where the revenue cycle lags behind services rendered. A botched EHR implementation can damage your revenue cycle for months to come, reduce patient confidence and harm your relationships with other health care providers. Moreover, a failing implementation might cause you to incur penalties from the federal government if your interim record-keeping doesn’t meet regulatory standards. Needless to say, it’s important to get implementation right. Here’s how to make sure your medical practice avoids a crisis scenario when transitioning to a new EHR system.
The steps of implementation
The first step involved in switching over to your new EHR system is tailoring the software to your medical practice. This is known as system configuration. The goal of this phase is to accurately represent the details of your medical practice and your patients’ information within the software. That means programming in the location(s) of your practice and the providers who will be using the system. You also need to design your practice’s clinical workflow, which includes the creation of clinical templates. Those templates are required to meet Meaningful Use and Physician Quality Reporting System standards outlined by federal regulations. Those rules will determine if your medical practice can qualify for incentive payments or if you will incur a financial penalty because you fail to meet the standards. During the system-configuration phase, your EHR will be integrated with your practice management (PM) system if it is not already. Also, any data stored within your old system will be migrated to the new one in this phase.
“An important component of putting a complete PM and EHR system in place is conducting a data import from the legacy system to the new system,” Adam Siegel, an EHR consultant for CareCloud, told Business News Daily. “A new software system will not automatically convert patients from one system to another. This is a complex process that must be facilitated by technical experts.”
Enrollment and credentialing
The next step required to set up your new EHR system is the all-important enrollment and credentialing phase. Enrollment and credentialing can sometimes be a drawn-out process, said Siegler, because it depends to some extent on the responsiveness of the payers. At best, changing payer enrollment from one practice-management system to another will take a couple of weeks, and at worst, the process can drag on for a few months. It’s imperative that you include enough time in the implementation process in case the enrollment and credentialing step takes longer than expected.
“Enrollment and credentialing is critical for accurate and consistent payment from insurance companies,” Siegel said. “The process can be drawn out depending on payer responsiveness and if the practice is represented as a group or individual providers.”
Getting this step right is crucial to ensuring smooth operations for your future revenue-cycle management, including getting accurate, consistent and timely payments from insurance companies. Still, you won’t want it pushing back your “Go Live” date, which would hinder your medical practice’s operations.
The final step is training your staff on how to use the new system. The details will vary based on your practice’s specific workflow, the different roles of your staff members and their preferences on how to engage with the new system. There are a number of different ways to bring staff members up to speed, but the key is to begin training a short time before the new EHR goes online, so staff members retain as much of the information as possible.
“Training is best done within a couple weeks of the Go Live date,” Siegel said. “This ensures that new workflow and process will be fresh in the minds of the staff. … Staff interact with their [practice management] and EHR systems constantly, and it’s important that they adopt the new system and look for ways to use it as efficiently as possible.”
Training options range from self-paced distance learning, which is the most affordable and simplest, to on-site, instructor-led training, which is a comprehensive, in person program. Self-paced distance learning involves reading user guides and watching instructional videos, which will help teach your staff how to use the new system. Of course, on-site training costs more, since a professional integrator will travel to your practice to train your staff, but it will ensure that even large staff gets one-on-one time with an experienced instructor who knows the ins and outs of the new system. Siegel recommended choosing less-robust solutions for practices with a smaller staff and going with on-site training for large practices or hospitals.
Troubleshooting and risk mitigation
Of course, no process is perfect, and with something as complex as EHR implementation, you’re bound to run into some problems along the way. As Siegel puts it, “The implementation process as a core principle involves stopping revenue through one channel and restarting it through another.” Naturally, this is a delicate and risky thing to do. Here are a few suggestions to employ in order to protect yourself against some of the potential issues surrounding implementation.
- Choose a system with a friendly user interface: Any EHR system has the ability to either streamline or hinder operations in your medical practice. To ensure the new system has the desired effect, make sure the user interface of whichever system you choose is intuitive and simple to learn. This will help make the transition easier for your staff and increase the effectiveness of your system, all without depressing productivity.
- Include your staff in the decision-making process: The best way to determine how prepared your staff is to adapt to the new system is by including them in the decision-making process. Do they find certain interfaces friendlier than others? What does their preferred workflow look like? What kind of training would they find most helpful? These questions can help you choose a system with your staff in mind and will make adoption of the new system much easier for them in the end. Involving each of the different departments in your practice during the decision-making process provides invaluable insight when making a final choice.
- Integrate all software with your new PM/EHR system: “Many practices use additional software products to provide the full spectrum of solutions needed to run an efficient modern medical practice,” Siegel said. “This starts with integrating any additional systems with the new PM and EHR software. Products like appointment-reminder systems and interfaces with lab and imaging systems are critical to practice efficiency and shouldn’t be overlooked during the conversion process.”
- Honestly assess your practice before implementation begins: It seems simple, but providing an honest and accurate assessment of your medical practice’s current finances, workflow and capabilities is a major part of devising a successful implementation. Through this assessment, and during the development of clearly stated future goals, a practice’s administration can more effectively set and track metrics of success for the new system. “A practice should have a clear understanding of how their complete practice will operate on the new system by the time they sign the contract and begin the implementation process,” Siegel said.
The payoff of a fully implemented EHR system
At the end of the implementation process, your practice will have a fully functioning, modern EHR system that will hopefully be a boon to both the quality of health care services you provide, as well as your practice’s profitability. Most practices, Siegel said, will have to go through the arduous process of implementation only once or twice in their entire lives, and if it’s done right, the rewards are exceptional. [Related Story: How to Open a Private Medical Practice, Step by Step]
Some of the benefits your practice should realize are:
- A more optimized day-to-day workflow and friendlier user experience
- More efficient, timely and comprehensive medical care for patients
- More complete documentation of patient visits and rendered services
- Greater patient satisfaction due to decreased wait times and simplified billing
- More efficient scheduling and increased appointments, as well as reductions in no-shows and cancellations
- Increased revenue and claims accepted by payers on the first submission, as well as a reduction in the amount of aging accounts-receivable in collections
- Improved connectivity with labs, hospitals and specialists that work with your practice
“By visualizing a modern medical practice and putting in place the right tools to manage it, a practice can put themselves in a grounded position of system optimization and excellence in performance poised for future growth,” Siegel said.
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