Steven Waldren, MD, director of the Center for Health Information Technology for the American Academy of Family Physicians, has helped many small physician practices implement and adopt EHRs.
At yesterday’s National Regional Extension Center & Health Information Exchange Summit West in San Francisco, Waldren shared best practices and lessons learned.
Before your office makes any changes, you need to have a financially stable practice, he said. Implementing an EHR is a major disruptive process and one that can shut a small practice down if it isn’t stable enough to endure a steep learning curve.
Next, you need to ensure that you have leadership, management and teamwork in place to guide the office through this transformative time.
Finally, small practices need to understand that implementing technology requires dedicating time for change management and process design.
Waldren outlined four steps to health IT adoption, and those steps must all be taken and in this order: preparation, selection, implementation and maintenance. Do not go directly to select. A lot of preparation must be done in order to determine how your office goes about selecting a vendor.
Waldren talked about driving quality with health IT. Meaningful use means being able to track and measure quality metrics for improved patient care. But you can’t measure if you can’t capture discrete data in a standardized form. That’s the value of health IT.
Small physician practices often ask how to embed knowledge into their system. Waldren recommends developing evidence-based documentation templates for your EHR.
The physician office needs to ensure that the system that is implemented needs to be reliable in order to track tasks and results.
Implementing a system will result in a shift of work among office staff. Take advantage of the technology to allow team members to do high-level task. In the meantime, remember to remove repetitive tasks and increase communication within the care team especially during the learning curve.
Finally, stop the paper chase; in other words, once you adopt health IT, don’t cling to the old processes.
Many physician practices won’t be able to go through this major transformation alone. They will need outside assistance to help them in many areas, including, aggregating and filtering the health IT chaos and noise. RECs can help with vendor contracting, provide basic IT assistance, help practices establish professional business practices, assist with project and change management, as well as process redesign. They can also be an advocate during implementation.
At a certain point, physicians need an assessment to determine technology requirements and build buy-in. They will also need to establish a long-term plan that takes into account the timeline for stages one through four and beyond.
