Dr. Robinson Implements an EHR System in a Small Physician Practice
Dr. Sloan Robinson is a family physician in a small practice in western New Jersey. With assistance from the New Jersey regional extension center, NJ-HITEC , Dr. Robinson implemented an EHR system in his practice. Initially, the practice found it difficult to justify implementing an EHR system, as the practice was already well-respected and profitable. But Dr. Robinson resolved to make his office electronic because he knows there are many benefits to EHR adoption, including improved quality of patient care and increases in practice efficiency.
EHR Implementation: Challenges and Solutions
The practice encountered three major challenges during EHR implementation: cost, staffing, and software.
- Cost – In order to purchase an EHR system, the practice had to secure a line of credit. In addition, the practice paid staff extra to help with the transformation. The investment was well worth the effort; all three physicians achieved meaningful use stage 1 and the meaningful use incentive payments helped address the financial challenges.
- Staffing – The practice faced two staffing challenges:
- First, three-quarters of the practice’s staff had been with the practice for over 12 years. Many are not part of the “computer generation” and several felt they might lose their jobs with the transformation. The staff who were knowledgeable about computers spent extra time helping their colleagues learn the new EHR system. Having super users help train coworkers when implementing new software is a demonstrated best practice. This is partially because team collaboration in the face of a changing work environment helps relieve tension in the workplace.
- The second staffing challenge was that staff felt scanning paper records and information into the new EHR was an insurmountable task. To balance the workload, the practice hired college students to help with the scanning. This reduced pressure on staff members and allowed the practice to quickly become fully electronic.
- Software – At the beginning, office staff spent many hours on the phone waiting for technical support. It was difficult to schedule a convenient time for in office training with the EHR vendor. After working closely the EHR vendor and expressing the needs of the staff, the EHR vendor agreed to have a trainer call the office each week at the same time to address concerns and provide support. In addition to the regular support calls, the EHR vendor also provided several in-office educational seminars. Regular and repeated software training made the EHR implementation process smoother. As this example illustrates, collaboration between providers, office staff and the EHR vendor is key to a successful EHR implementation process.
Achieving Meaningful Use and Next Steps
With support from the New Jersey regional extension center, Dr. Robinson’s practice successfully implemented an EHR system and all three physicians achieved meaningful use stage 1. Dr. Robinson believes time, hard work, flexibility, a supporting staff, and an understanding patient base is the foundation to a successful transformation. Looking forward, the practice is preparing to use the EHR to track diseases and quality of life measures, which will help provide even better healthcare to patients.