There is no doubt that Electronic Medical Records (EMR), implemented successfully and used properly, are valuable clinical tools in any medical practice. Their benefits of reducing costs, streamlining workflow, improving medical care and increasing practice productivity are undeniable. However, we hear stories upon stories of failed implementations and deinstallations of these systems across the US. According to a study conducted by HealthLeaders-InterStudy that “The state of Arizona and the Phoenix area have experienced a high adoption rate for electronic medical records, but this has been followed by a “deinstallation” of the technology”.

What should physicians and practices do to prevent and avoid such a failure? To thoroughly answer this question, we must start at the beginning of the process of changing from paper to electronic. It is very important for everyone involved to understand the implications and ramifications of this very important change. A practice profiling or readiness assessment and aptitude for embracing and adopting new technology is the first step to ensuring a successful EMR implementation long before the deployment of the system.

In this first article, of a series of future articles, we will focus on what is involved in performing EMR readiness assessment and briefly explain each task. These tasks lay the ground for the needed changes and the necessary training and support as the EMR implementation process proceeds.

• Assessing your practice culture:
Understanding the office culture and it aptitude for change is considered a major factor of the successful implementation of an EMR. Cultural assessment includes:
o Staff willingness to accept change and to be able to change they way they do things.
o The change in workflow and processes and its impact on how staff interact with each others
o The level of resistance to change – real or perceived.
o The cause of resistance and possible remedies.

• Assessing your practice technical capabilities:
o Identify current technical skill level. You might find some of your employees are less tech-savvy than others. It is very important to determine their skill level to help you design a training program to bring everyone up to the required skills level prior to deploying the EMR software.
o Identify the impact the EMR would have on your existing technical environment.

• Assessing your operational changes:
o Front Office – receptionists, patient scheduling, checking-in, checking-out, processing insurance related information, etc.
o Nurses – interacting with patients, interacting with physicians, etc.
o Administrative and Back Office – coding, billing and accounting.
o Physicians – entering encounter information, dictations, medications, test results, etc.

• Assessing your budget, cost, saving and ROI:
o Identify the impact and the cost of acquiring an EMR on your budget.
o Identify the impact on your patients volume and revenue.
o Assess the loss of practice productivity during and after transition to EMR
o Asses the impact on account receivables and the decrease in cash flow.
o Identify areas of saving and cost cutting as a result of deploying an EMR.
o Identify positive and negative impact on the practice bottom line

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