Tips for Switching to EHRsJan 23, 2020 | Jonathan Maisel
Electronic health record (EHR) systems are becoming ubiquitous in healthcare. Switching from paper charts to EHR systems can feel like quite the challenge, especially for small practices that don’t have an in-house IT team to smooth out the process.
However, the difficulties involved can be minimized with a bit of preparation, and the benefits of implementing an EHR are significant. We’ll go over what you need to know about moving from paper to electronic records so you can confidently make the change.
Why Practices Are Switching to EHRs
EHRs are everywhere. The most recent figures state that 86% of office-based physicians have adopted an EHR, up from just 42% in 2008. What is driving this rate of adoption?
In 2011, the Centers for Medicare and Medicaid Services (CMS) established an incentive program with the intent of spurring electronic medical record (EMR) adoption. If providers met the requirements of the program, they could receive increased Medicare reimbursement. The incentive program was created in three stages:
- Stage 1 established requirements for electronic capturing of clinical data and providing patients with digital copies of their health information.
- Stage 2 focused on using EHRs to meaningfully advance clinical processes and using certified EHR technology (CEHRT) to continuously improve care quality and information exchange.
- Stage 3 focused on continuing to improve health outcomes with the use of CEHRT.
This incentive program has been replaced by the Promoting Interoperability (PI) program, the focus of which is facilitating patient engagement and information exchange using CEHRT. PI is nested under the Merit-based Incentive Payment System (MIPS) and makes up 25% of a clinician’s total MIPS score. To get the points for the PI program, clinicians must be using a 2015 Edition CEHRT, meaning that practices without an EHR are leaving money on the table.
Benefits of Switching to an EHR
Although federal incentives are perhaps the most significant driver of EHR adoption, the benefits of electronic medical records in hospitals and other healthcare organizations are clear.
1. Reduced Storage
Paper records take up a lot of physical space that any healthcare organization could better use for another purpose. With paper records, providers must keep all patient information on file and have to have the files readily accessible for several years to meet certain regulations. Implementing EMR in hospitals can free up multiple rooms for other, more pressing uses.
2. Ease of Access
Digital records offer unprecedented access to the providers who need it. When lab results are ready, a physician can access them almost immediately. Different departments treating the same person can add clinical information instantly, without having to dig up the location of a paper medical record and check it out. In a contest of paper vs. electronic medical records, EHRs win on access.
In organizations with multiple facilities, all locations can access the person’s health record without having to go through mail or faxing. When providers can find the information they need promptly, patient satisfaction goes up and workflows become more efficient.
3. Improved Accuracy
Physicians are not known for their legible handwriting, and handwritten charts have some of the same issues as handwritten prescriptions. Errors caused by illegible documentation are greatly reduced with the use of an EHR, as each entry into each field is completely legible. Additionally, many EHRs have a feature that will check for missing information and prompt its entry.
4. Reduced Costs
The initial cost of implementing an EHR is a significant investment, but using the system properly will allow providers to recoup those costs quickly. Paper medical records come with the need to pay more personnel to manage, file and access the physical charts, and the need to designate space just for those activities.
5. Increased Risk Management
Once all patient information has been documented in digital form, it becomes easier to track clinical issues and better identify areas of significant risk. For instance, some EHRs can raise a red flag if a clinician prescribes a medication that has interactions with another drug in a patient’s chart.
The risk of theft goes down when there are no physical records for someone to walk out with. Access controls help lock out unauthorized users from accessing the data, and features like audit logs help providers know exactly who interacted with patient information in what way.
How to Switch to an EHR: 9 Tips
Switching from paper charts to EHR systems can be a complex process, and it will affect every person on your staff. There is a bit of a learning curve to navigate, but having a plan in place beforehand can make the whole process unfold more smoothly. Here are nine tips for moving from paper to electronic records.
1. Build an Implementation Team
You’ll need to form a strong team to facilitate the implementation of your EHR. The team should include at least one staff member of every type, such as doctors, nurses, assistants and administrative employees. One critical step is to designate one or more “superusers.”
Superusers are members of the staff who have been thoroughly trained on the EHR and can share tips and techniques with their colleagues. They function as internal trainers and help spread the responsibility of training the full team.
2. Prep the Software
Before full implementation, it’s essential to make sure the software is configured correctly in terms of security features. This may include conducting a HIPAA security risk assessment. Your health IT vendor can explain how to do this or may assist you in making sure you have it set up correctly for HIPAA compliance.
3. Decide on Hardware
Your EHR software may require a change in hardware. For instance, it is likely very inefficient for physicians to have to log in and out of each computer in each room, so they might benefit from having a tablet or laptop to take with them between rooms. Likewise, having a printer in every room can save significant time otherwise spent walking back and forth to the printer location.
4. Determine Room Layout
EHRs require a substantial amount of typing and clicking to get a sufficient amount of information into the record. The placement of furniture can deeply affect how patients perceive their interactions with the physician and staff. If the staff and doctor are facing away from the patient to create documentation, the patient may feel they are being neglected.
One simple way to solve this is by arranging things in a triangular shape. The patient, doctor and data entry computer align in a triangle formation, so the doctor is partially facing the patient for increased interaction, and the doctor only has to turn a little bit when accessing the computer.
5. Transfer the Data
After the software has been assessed and configured and your room layout is optimized for EHR data entry, the next step is to transfer the data itself. Consult your IT team or EHR vendor to find out the most efficient way to migrate data from paper, as it may vary between software.
Someone will have to perform the migration, so consider whether you want to assign current staff or hire temporary employees to upload the data to the new system.
Developing a priorities checklist is one way to make this process go smoothly. Know what you need to go into the EHR before starting the migration to help ensure you don’t miss any crucial information.
6. Establish Workflows
Your new EHR will change the way your organization operates, depending on its features. To minimize stress after implementation, establish your new workflows and give your team the opportunity to become familiar with them before the EHR is implemented. If you leave everyone to figure out their own new workflow after the system is in place, you risk team morale and increase the chance of avoidable errors occurring. When designing your new workflows, ask these questions:
- Is this step necessary?
- Does this step add or reduce value for the patient?
- Does this step create better efficiency for the staff?
- Could this flow be ordered differently?
- Is the most appropriate staff member performing this step?
7. Create a Training Program
It takes significant training time for everyone on the team to successfully learn how to use the EHR. Every staff member will likely need to use the system at some point, and every employee should receive the training they need but not more than that. For example, a doctor needs to know almost every aspect of the EHR, but someone working in the front office may only need to learn how to use the scheduling and patient communication features.
To create your training program, seek input from people in each role to ensure you are not wasting time and creating stress by over-training. Then bring in your superusers and take the time necessary to ensure everyone is up to speed with the new system.
8. Determine Your Launch Approach
There are two types of launch approaches you have to consider. One is the “big bang” method, where all elements of the EHR go live at one time. If your practice is small, this may a good way to go. For larger organizations, implementing an EHR works better with an incremental approach.
Implementing one function at a time and introducing other features one by one allows for better management of disruption that occurs when the launch doesn’t go perfectly smoothly. It also gives EHR users a chance to truly learn each function before the next one arrives, leading to more cemented knowledge.
9. Gather Feedback
Because everyone on the team is involved in using the EHR, it’s essential to gather feedback on how implementation has gone and how team members feel about the new workflows. Keeping communication open on the new EHR can bring to light inefficiencies and other issues that may hinder your organization from reaping the full value of your investment.
Start by having regular meetings in the first few months after implementation. After scheduled meetings have ceased, make sure the staff knows they are welcome to voice any concerns and provide other feedback as time goes on.
How Medical Transcription Makes the Transition to EHRs Easier
So where does medical transcription fit in when implementing EMR in hospitals and private practices? These benefits make the transition smooth.
1. Improved Accuracy
While the purpose of EHRs is to make data entry more accurate, it doesn’t always turn out that way. Especially in the beginning, it’s quite easy for clinicians to click the wrong drop-down box or accidentally mistype a code. However, if the doctor is dictating the notes out loud, they are less likely to make verbal mistakes.
2. Makes Documentation Easier
Manually entering data into the EHR requires a significant amount of typing, clicking and editing after the fact. Doing this while also engaging with the patient is difficult, to say the least, and the multitasking can reduce patient satisfaction.
With medical transcription, all the physician has to do is speak into a recorder, smartphone app or phone to record their notes. This intuitive approach doesn’t require learning a complex interface and doesn’t require the physician or another staff member to spend time editing the documentation afterward.
If you’re using a service that offers medical transcription with EHR integration, there is even less burden on staff as the service will insert the completed documentation into the EHR automatically.
3. More Time for Core Activities
The greatest drawback to an EHR is that the documentation is time-consuming, but with medical transcription, this drawback disappears. The physician only spends the time necessary to articulate their notes, and can then move on to the next patient without spending further time adjusting or correcting their notes.
4. Cost Saving
Working with a medical transcription service is significantly more cost-effective than hiring an in-house transcriptionist. You don’t need to worry about salary, taxes, insurance or the cost of training.
5. Makes Information Readily Accessible
A service with EHR integration gives physicians as well as patients critical health information almost instantaneously. As soon as the transcriptions are complete, they can be inserted into the EHR for immediate use in insurance reimbursement or clinical decisions. If a patient forgot critical instructions from the physician, they can simply log into their patient portal and go over the notes as soon as the documentation is finished.
Can ZyDoc Improve Your EHR Transition?
Transitioning from paper charts to an EHR is a daunting task, but you can make it simple and smooth by creating a plan and taking advantage of medical transcription services. ZyDoc has been providing award-winning documentation advancements for more than 25 years, and we understand the critical role of documentation in EHR use.
ZyDoc allows physicians to embrace EHR documentation with our more intuitive and affordable dictation system. Clinicians can create documentation 61% faster than with manual entry and receive finished notes with 99.6% accuracy in a two-hour turnaround time frame.
If you’d like to explore the possibilities of ZyDoc, take a look at our plans and pricing. When you’re ready, sign up for a no-obligation 14-day trial to see how ZyDoc can make your new EHR work better for your organization.