Implementing an EMR system within your practice is not as easy as taking the software right out of the box and installing it. In fact, that is about as far from the truth as to how the process really works.

Implementing electronic medical records is a daunting task for most practices and the federal government estimates that the EMR failure rate tops out at 30 percent.

For clarification’s sake, some of the failures are due to software and hardware issues but most of the time; the problems are due to human error – poor planning, lack of communication, and poor training.

The biggest challenge with EMR implementation is managing the people involved, not the actual software or hardware that is being installed. When you implement an EMR system in a practice, you are basically asking the staff to learn new skills and change their daily work habits. Change within a medical practice can be a challenging thing to take on.

The first step in the implementation process is to establish a project team. Who all is on your team will obviously depend on the size of your practice. If you are a soloist, you are technically the project manager although you may delegate some responsibilities to others.

A project manager will also be necessary to coordinate the rollout with your EMR vendor. Typically in a small office the office manager will play this role. Larger practices with several physicians may need to hire a full-time project manager on a temporary basis or consider utilizing a consultant.

If you are a small office, it’s critical that you include everyone on the implementation team. If you don’t include everyone on the team and exclude certain folks from giving their input, don’t expect them to buy into using the EMR system. In a larger practice, you’ll want to get everyone’s opinion but you’ll obviously have to limit your implementation team’s size to maintain efficiency. It’s critical that you recruit members to the team from each department within your practice – front desk, clinical, medical records, billing, and administrative. It’s critical that you choose individuals from each department that are enthusiastic about the project and open minded to change and recommendations.

When it comes to the time frame associated with rolling out an EMR system, there are typically two approaches that are taken. The first is based on the “big bang” theory, meaning on a single day you switch over to the new system and immediately go live with it. The second approach is incremental and consists of implementing various features of the EMR system over a period of six months to a year.

The big bang approach allows you to implement your EMR system immediately and therefore achieve a quicker return on your investment. The down side to this approach is that it can create total chaos and lead to such frustration that end users abandon the EMR system.

Incremental implementation is generally easier for end users to accept and adapt too. If the EMR system has a billing and scheduling module, implement that first to make sure your practice will get paid. Then consider implementing e-prescribing and intra-office messaging. The idea is to implement the features first that are going to give your practice the biggest gains in efficiency. As end users begin to see the efficiencies gained, the system will widely become more accepted.

The last phase should be charting patient encounters with the templates that come with the program as many doctors find this part of the process the most frustrating. If you customize your templates, the key is to keep them as simple as possible so that all parties that will be using them will be happy with the system.

The next critical step in the implementation process is to make sure that everyone receives proper training and is comfortable using the system. Someone who doesn’t know how to navigate their way through a program with confidence will likely abandon the system.

You have to keep in mind that you will be working with people that have different levels of technological skills. This means you are going to have to assess the basic computer skills of everyone in your practice. The key is to gear EMR lessons to the lowest common denominator so that no one gets left behind. If you don’t bring everyone up to speed and get them on the same page, some folks may get left behind and be unsatisfied with using the system.

Once training is complete and your staff feels competent about using the system, it’s time to migrate to using it on the job. If you decide to take the incremental approach, every newly introduced functionality will have a “go live” day. The key is to give each function a trial run ahead of time before taking it live to ensure that the software and hardware are working.

The biggest challenge of going live will be when your practice switches from using paper charts entirely to using the EMR for charting patient encounters. The key is to plan ahead and go live during a slower time of the year.

During the first week of going live it’s a good idea for your staff to meet frequently to discuss your progress, identify problems and address any additional training needs.

The biggest key to success when implementing an EMR system is to make sure your team is dedicated to achieving success and that everyone is motivated towards achieving the same goal. Make sure and set realistic expectations and reward staff for meeting these goals.

Make sure and listen to all concerns and complaints during the process and address these issues as they come up. People want to give their input and feel like a part of the team even if they don’t expect everything to go their way. Listening becomes an important skill when working with doctors who are learning the ropes of a new EMR system.

Unaccepted adoption of an EMR system among doctors in a group can be a total failure, because they end up with two parallel record systems – one on paper, one electronic – along with two different workflows. If this occurs, you can forget about achieving that desired return on your investment. The goal is to have a doctor that truly believes in the EMR implementation and have him or her work with others that are skeptic in order to get them on board with using the system.

The most important part of the implementation is one hundred percent commitment through out the entire process. There will be times when the work is hard and frustrating but in the end, once the EMR has successfully been implemented and accepted, the benefits received will far out weigh the challenges that your practice had to over come to get there.