John Lubrano, PhD, founder and owner of Protis I.T. Solutions, specializes in office automation and EHRs for medi- cal practices. Dr. Lubrano, TMA Practice Consulting’s technology expert since 2004, coauthored the Electronic Medical Record Implementation Guide. He says physicians often are unhappy with their EHR adoption when their ex- pectations don’t meet reality. “There’s a lot of due diligence that has to happen on the part of the physician. They can’t just take a colleague’s word for it that the product will work for their practice. That’s not really vetting the products in relation to the practice and not setting the expectations properly,” he said.
He adds that vendors feel tremendous
pressure to provide practices with effec- tive trainers and implementers. “With the high demand for EHRs, it’s possible that not all of the trainers have a lot of experience with the new sys- tems. It’s a good idea for physicians to ask how many implementations the ven- dor’s trainers have done with the new platforms,” Dr. Lubrano said. The implementation phase is perhaps the most crucial step of the entire EHR adoption process. The Electronic Medical Record Implementation Guide outlines several techniques that have contributed to the success of EHR implementation, including:
• Appoint someone as implementer to coordinate HIT adoption to make sure it moves forward. Physicians should consider bringing in a temporary em- ployee experienced at handling logis- tics or a consultant experienced in HIT implementation.
• Monitor costs. After accepting a vendor proposal, physicians should understand that changes made mid- stream can be expensive. Before making changes, physicians should always ask the vendor how much it will cost and to provide a note revis- ing the original estimate.
• Take steps to catch up if the practice falls behind in workflow redesign. De- pending on level of experience with HIT implementation, the implement- er may be able to facilitate workflow
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