10 insights on best EMR practices after the go-live

Health IT executives consider huge range of factors when selecting an EMR platform., but the days following implementation are the ones that test whether the vendor the organization selects is going to meet its needs.

Steve Morgan, MD, senior vice president for information technology and data analytics and CMIO for Carilion Clinic in Roanoke, Va.; Keith Moss, MD, vice president and CMIO for Riverside Healthcare in Peotone, Ill.; Tom Barnett, vice president for application services health information technology at Northshore University HealthSystem in Chicago; and Michael Blackman, MD, CMO for McKesson Technology Solutions in San Francisco shared their thoughts on best EMR practices after implementation during a roundtable at the Becker's Hospital Review CIO/Health IT + Revenue Cycle Management Summit in Chicago on July 21.

Here are 10 insights from the event.

• It is all too common for providers to wrestle with disparate systems, sometimes dozens of them. Whittle them down to a single basic platform when possible to systematize workflow in a clinical environment.

• As data is integrated, there's a risk of loss of workflow and continuity. In those instances, entertaining the use of add-ons is an option to curb that loss of continuity.

• When considering consolidating or paring down to one main platform, physician buy-in from the beginning is one of the most important elements, along with taking on initiatives such as patient portal web access and mobile phone access, ideas that are trending in health IT.

• The "look" of a new system can have just as much impact as its functionality in adoption, use and satisfaction.

• Although disparate systems can be cheaper to maintain overall, important data will almost always fall through the cracks due to interoperability issues. These problems are less likely to arise when working off of a single base platform with add-ons tailored to interact with it.

• Experimenting with policies about which treatment team members input information and orders into the system may be an effective way to increase productivity and decrease physician complaints about too little face-time with patients.

• Changing human behavior is still an enormous difficulty for many systems following the implementation of an EMR. Dedicating training time on a regular basis for each department will enable all members of a care team who enter information and maintain records to be aware of how a record should look.

• From the vendor perspective, most systems underinvest in training users following EMR implementation.

• It can take a long time — sometimes years — for an EHR to become part of the culture of the organization.

• A part of every information officer's job is to spend time with clinicians using the organization's health IT on the front lines to know their concerns and facilitate a dialog between user and vendor.

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