The R&D MedTech Advantage
You are preparing to make a significant investment in EHR - and the health of your practice. R&D MedTech will be with you every step of the way - from initial reserach through implementation and data mangement. Our consultative culture ensures that your approach is well planned and team well trained to guarantee you get the biggest possible return on your EHR investment.
R&D MedTech: Helping you plan, train, and implement your way to EHR success.
Everyone in your practice will play some role in the success or failure of your EHR implementation. Some roles will be bigger than others, but they all need to be acknowledged and understood from the start. When you define these roles, your EHR is an important team member.
Types of leaders. Study after study on EHR implementations reports the same thing: People are key, and leadership is one of the biggest issues. An EHR project needs two leaders: a physician champion (or two or three) and a skilled project manager.
The physician champion should be a respected clinician who is a good communicator and a tireless supporter of the project. He or she should be the engine that motivates others. Physician champions are so important that one report stated, "Identify an EMR champion - or don't implement."
The project manager should not be just any available manager. Rather, he or she should be someone who is trained, skilled and experienced in managing complex projects with overlapping timelines and multiple stakeholders. He or she will be the engineer that keeps the train on track and anticipates the stops ahead. Most practices will likely partner their office manager with an implementation project manager assigned by R&D MedTech.
The R&D MedTech implementation project manager will have experience with EHR implementations and will be able to provide weekly status reports on the progress of the implementation to your practice’s project manager. These regular interactions not only keep everyone focused on schedule and budget but the communication channels prevents problems before they impact the EHR implementation as risks.
Change management. Not only does an EHR project need good management, but it also needs broad stakeholder involvement, a motivated implementation team and an excellent communication plan. Unfortunately, installing an EHR is not like installing a new program on your home computer. You cannot simply load it, learn how its features work and proceed with patient care. EHRs are much more complex.
You will need to understand the enormous Greenway EHR capabilities and determine how they can be used to streamline and improve current paper-based office processes. Using an EHR will allow for more efficient workflow and offer an opportunity for you to improve your office efficiency and service level, but that isn't automatic.
This means change, and change is a dirty word to many people. It inspires fear, resistance and sabotage. Understanding and utilizing a good change management process will help. At R&D MedTech, our team has years of experience performing change management in the information technology arena. We will assist your staff to facilitate the change in order to maximize your EHR implemmentation.
Activities
New questions will pop up almost every day while you're doing an EHR implementation. With the right tactics in place from the beginning, you'll have answers ready - for most of them. Some of the activities R&D Medtech will help you practice contemplate and implement include: workflow redesign, scanning strategy, data entry, electronic interfaces phased implementation, training delivery methods, note design, going live, and customer support and maintenance. These areas are discussed in depth below.
Plan, plan, plan. It can't be said enough. Much of an EHR implementation's eventual outcome depends on the planning you do long before you go live. Write the plan down. Use project management software. Talk to experts and other users. Visit other implemented sites. Do not wing it.
At R&D MedTech, we develop a tailored Microsoft Project Plan for each client practice after meeting with key stakeholders. This plan is tracked and reported on regular basis.
Workflow redesign. A key piece of planning frequently mentioned by EHR implementation experts is "workflow redesign." An EHR implementation offers you an opportunity to improve some of your less efficient processes through automation and fewer steps.
Ideally, for each major office process, you should review the current paper process, analyze its steps and record them on a flow diagram. You can then determine if the process can be improved by comparing it to a flow diagram you create of an EHR process that accomplishes the same thing. Office processes that you should examine include medication refilling, telephone messaging, appointment requesting, lab reviewing, other test reviewing, prescription writing, patient check-in, health maintenance tracking, referral making, lab and test ordering, communicating test results to patients, interoffice messaging and note charting. R&D MedTech works with your practice's management to discuss current workflow, possible improvements with EHR and how to move across the gap between the current and future states. Included in this discussion is timeframes, costs, staff concerns, etc.
Scanning strategy. When should you start and how much of an old paper chart should you scan when you initiate your EHR? This is a topic of some debate in the EHR world, and no single answer will suit all users. One strategy is to scan in records of patients with scheduled appointments just before they come in. Eventually, as the volume of the first EHR visits decrease, a practice can start scanning in charts for any patients who make phone contact with the office. Another strategy would be to spend six months before your go-live date trying to intensively scan in all your charts. This would likely require extra personnel and more than one scanner.
That answers "when," but what about "how much"? One possibility is to scan in as much as possible into one electronic file. But that isn't terribly useful, because to find anything in the old paper record would involve browsing through that entire electronic file. Another possibility is to divide those same 200 scanned pages into subfiles using easily retrievable categories such as "urology consult," "ECG," "echo," "brain MRI," "chest CT," "progress note" and "comprehensive exam." This could conceivably require filing 200 pages in 100 categories, and that isn't tenable either. It might take a staff member much longer than an hour to scan one chart. At that rate, your staff will quickly fall behind. The right answer involves a compromise somewhere between these two approaches. You'll find your answer by balancing your physicians' need to minimize the time they spend searching for scanned data in an EHR with how much staff time you're willing to spend on scanning.
R&D MedTech helps its client practices find ways to discretely scan in the key data needed 90 percent of the time and to bulk scan the rest. The practice can then shred its charts. The practice may end up with more room in its office and get many old charts out of storage. In some offices, depending on design, old chart rooms can even be converted to productive exam room space. Read more
Data entry. To get value out of an EHR, it's critical to maintain problem lists, medication lists and allergy lists. But who enters that data and when? Again this is an issue you'll need to decide during implementation. In one office, medical assistants entered medications and allergies from the old chart, and physicians entered the problem lists. This was done just before an upcoming appointment, and then the chart went to scanning. That meant that the first time we saw the patient after going live, we had a completely functional electronic chart and no longer needed the paper one. Some offices hire registered nurses to help with problem entry. Others never get around to completing the data entry and thus have less than fully functional EHR systems.
Read more to see how R&D MedTech leverages PrimePatient to benefit your practice and eliminate certain data entry tasks.
Electronic interfaces. Generally the more options you have to get information into the EHR electronically, the better. A practice management interface is essential if you have a stand-alone EHR product. Otherwise you will have to do double entry of all patient demographics.
Lab interfaces should be a high priority. With them, you will have a much easier time finding the specific lab result you're looking for than you would if you were using paper, and you might even be able to flowchart or graph trends in specific lab values, like all of a patient's A1C rates for the last several years. Without a lab interface, you will have to scan in lab reports and be no farther ahead than you were with paper reports, or you or your staff will manually enter lab values, a labor-intensive process. Contact us to see how R&D MedTech utilizes PrimeExchange to accomplish this important activity.
Big bang vs. phased implementation. Should all physicians go on the system at once? Should you start all functions at once? Ideally, all physicians in one office should go on the EHR together. Otherwise, the office staff will need to run at least two different sets of processes for paper-based physicians vs. EHR physicians. Not only is that confusing, but it also is inefficient.
However, if your practice has more than one office, there is no overriding reason that all practices have to go on the EHR at one time. In fact, depending on your practice's resources, you might be wiser to roll out one office at a time.
A few practices have successfully implemented all functions of an EHR at once. This can be called "big bang." The consensus, however, is that success is more likely if you implement functions sequentially in what is known as "phased implementation."
R&D MedTech works with each client practice to formulate the implementation that makes the most sense to that practice.
Training. We can facilitate your training at our headquarters, at an off-site location close to your practice, or in your own office practice environment. The Go-Live deployment training is always conducted on-site at your practice. When comparing our solution to our competitor's, this is an important differentiator as the success of on-site training implementation is much higher than the web-based training solutions offered by our competitors.
Tailored Instruction: To make the transition to EHR as easy as possible, following the training and go-live phases, we provide client specific and tailored instructions for each job function. This resource is a valuable guide each member in the practice becomes familiar with the EHR system. This includes everything from accounts receivable monitoring to physician specialty template customization.
Onsite Training: When practices look to "Go electronic", they reach for their most common real-life experiences to guide them, cognitively, about "What is this going to take?": For most people, that's installing some software on their computer.
The problem is, this experience is a poor model to understand EHR implementation:
1. It implies “This is something you can do with an instruction book and maybe a little help”.
2. It implies “This is something that is experienced at the computer, and the computer only.”
3. It implies “It generally takes a week or two to 'get really good' at it.”
What it misses is:
1. EHR implementation means a THOROUGH examination of all of your clinical workflows and then in some cases, reorganizing them under a new electronic paradigm.
2. “Support” is NOT an instruction book, and NOT a 2-hour class, but a continuous, ongoing monitoring of physician, nurse, and practice management behaviors - And to achieve this requires an entire support mechanism of its own.
3. The 'learning curve' is often longer than anticipated.
R&D MedTech believes there is a higher probability for a successful implementation if training is delivered in person as opposed to over the web or from a CD. Our trainers are certified by Greenway after intensive classroom and shadowing experiences.
Note design. R&D MedTech will train users on the thousands of standard Greenway Primesuite note templates that span over thirty specialties and subspecialties. However, given the variation in how physicians practice medicine, you will most likely decide to utilize the ability to easily customize these templates in the Greenway software to suit your practice style. Some practices develop dozens, even hundreds, of templates for use in a wide variety of clinical situations.
However, you'll need to consider how much leeway each physician should have on customized templates. For example, should your practice design one common template for the medical group on diabetes? Or would it work better if you allowed each physician or practice site to create a customized variation? If you are using a template for the purpose of disease management, then it makes sense to standardize. Otherwise, allowing individual variations will likely promote higher EHR utilization and efficiency among your physicians. R&D MedTech can assist with this process, because once your physicians and practice manager have attended our template modification course, they can perform this activity with little or no outside assistance because Greenway functionality is very user friendly.
Going live. After extensive preparation, turning your system on, or "going live," should be uneventful. Given that Mondays are your busiest days, they are a bad choice for a "go live" day. Pick any other day. Make sure your physicians have lighter-than-normal schedules - ideally about a 50-percent workload. Most practices do this for the first two weeks and then resume normal schedules. This will vary depending on your implementation's design. R&D MedTech works with your practice's management team to coordinate the schedule that works best for you.
Support. Adequate vendor support is essential for success. R&D MedTech will respond to your calls for help quickly as part of its guarantee. In fact, we track our help desk response times and numbers of outstanding "help tickets" for each practice and can provide you with those reports if you are interested. Both R&D MedTech's and Greenway's track record for customer support is ranked high in customer satisfaction as evidenced by our help desk tracking and KLAS ranking in this area. This speaks to the importance of thoroughly investigating your vendor and the product before you sign the contract.
For more information on R&D MedTech’s philosophy of service to our client practices, please call 918-682-2285.
Everyone in your practice will play some role in the success or failure of your EHR implementation. Some roles will be bigger than others, but they all need to be acknowledged and understood from the start. When you define these roles, your EHR is an important team member.
Types of leaders. Study after study on EHR implementations reports the same thing: People are key, and leadership is one of the biggest issues. An EHR project needs two leaders: a physician champion (or two or three) and a skilled project manager.
The physician champion should be a respected clinician who is a good communicator and a tireless supporter of the project. He or she should be the engine that motivates others. Physician champions are so important that one report stated, "Identify an EMR champion - or don't implement."
The project manager should not be just any available manager. Rather, he or she should be someone who is trained, skilled and experienced in managing complex projects with overlapping timelines and multiple stakeholders. He or she will be the engineer that keeps the train on track and anticipates the stops ahead. Most practices will likely partner their office manager with an implementation project manager assigned by R&D MedTech.
The R&D MedTech implementation project manager will have experience with EHR implementations and will be able to provide weekly status reports on the progress of the implementation to your practice’s project manager. These regular interactions not only keep everyone focused on schedule and budget but the communication channels prevents problems before they impact the EHR implementation as risks.
Change management. Not only does an EHR project need good management, but it also needs broad stakeholder involvement, a motivated implementation team and an excellent communication plan. Unfortunately, installing an EHR is not like installing a new program on your home computer. You cannot simply load it, learn how its features work and proceed with patient care. EHRs are much more complex.
You will need to understand the enormous Greenway EHR capabilities and determine how they can be used to streamline and improve current paper-based office processes. Using an EHR will allow for more efficient workflow and offer an opportunity for you to improve your office efficiency and service level, but that isn't automatic.
This means change, and change is a dirty word to many people. It inspires fear, resistance and sabotage. Understanding and utilizing a good change management process will help. At R&D MedTech, our team has years of experience performing change management in the information technology arena. We will assist your staff to facilitate the change in order to maximize your EHR implemmentation.
Activities
New questions will pop up almost every day while you're doing an EHR implementation. With the right tactics in place from the beginning, you'll have answers ready - for most of them. Some of the activities R&D Medtech will help you practice contemplate and implement include: workflow redesign, scanning strategy, data entry, electronic interfaces phased implementation, training delivery methods, note design, going live, and customer support and maintenance. These areas are discussed in depth below.
Plan, plan, plan. It can't be said enough. Much of an EHR implementation's eventual outcome depends on the planning you do long before you go live. Write the plan down. Use project management software. Talk to experts and other users. Visit other implemented sites. Do not wing it.
At R&D MedTech, we develop a tailored Microsoft Project Plan for each client practice after meeting with key stakeholders. This plan is tracked and reported on regular basis.
Workflow redesign. A key piece of planning frequently mentioned by EHR implementation experts is "workflow redesign." An EHR implementation offers you an opportunity to improve some of your less efficient processes through automation and fewer steps.
Ideally, for each major office process, you should review the current paper process, analyze its steps and record them on a flow diagram. You can then determine if the process can be improved by comparing it to a flow diagram you create of an EHR process that accomplishes the same thing. Office processes that you should examine include medication refilling, telephone messaging, appointment requesting, lab reviewing, other test reviewing, prescription writing, patient check-in, health maintenance tracking, referral making, lab and test ordering, communicating test results to patients, interoffice messaging and note charting. R&D MedTech works with your practice's management to discuss current workflow, possible improvements with EHR and how to move across the gap between the current and future states. Included in this discussion is timeframes, costs, staff concerns, etc.
Scanning strategy. When should you start and how much of an old paper chart should you scan when you initiate your EHR? This is a topic of some debate in the EHR world, and no single answer will suit all users. One strategy is to scan in records of patients with scheduled appointments just before they come in. Eventually, as the volume of the first EHR visits decrease, a practice can start scanning in charts for any patients who make phone contact with the office. Another strategy would be to spend six months before your go-live date trying to intensively scan in all your charts. This would likely require extra personnel and more than one scanner.
That answers "when," but what about "how much"? One possibility is to scan in as much as possible into one electronic file. But that isn't terribly useful, because to find anything in the old paper record would involve browsing through that entire electronic file. Another possibility is to divide those same 200 scanned pages into subfiles using easily retrievable categories such as "urology consult," "ECG," "echo," "brain MRI," "chest CT," "progress note" and "comprehensive exam." This could conceivably require filing 200 pages in 100 categories, and that isn't tenable either. It might take a staff member much longer than an hour to scan one chart. At that rate, your staff will quickly fall behind. The right answer involves a compromise somewhere between these two approaches. You'll find your answer by balancing your physicians' need to minimize the time they spend searching for scanned data in an EHR with how much staff time you're willing to spend on scanning.
R&D MedTech helps its client practices find ways to discretely scan in the key data needed 90 percent of the time and to bulk scan the rest. The practice can then shred its charts. The practice may end up with more room in its office and get many old charts out of storage. In some offices, depending on design, old chart rooms can even be converted to productive exam room space. Read more
Data entry. To get value out of an EHR, it's critical to maintain problem lists, medication lists and allergy lists. But who enters that data and when? Again this is an issue you'll need to decide during implementation. In one office, medical assistants entered medications and allergies from the old chart, and physicians entered the problem lists. This was done just before an upcoming appointment, and then the chart went to scanning. That meant that the first time we saw the patient after going live, we had a completely functional electronic chart and no longer needed the paper one. Some offices hire registered nurses to help with problem entry. Others never get around to completing the data entry and thus have less than fully functional EHR systems.
Read more to see how R&D MedTech leverages PrimePatient to benefit your practice and eliminate certain data entry tasks.
Electronic interfaces. Generally the more options you have to get information into the EHR electronically, the better. A practice management interface is essential if you have a stand-alone EHR product. Otherwise you will have to do double entry of all patient demographics.
Lab interfaces should be a high priority. With them, you will have a much easier time finding the specific lab result you're looking for than you would if you were using paper, and you might even be able to flowchart or graph trends in specific lab values, like all of a patient's A1C rates for the last several years. Without a lab interface, you will have to scan in lab reports and be no farther ahead than you were with paper reports, or you or your staff will manually enter lab values, a labor-intensive process. Contact us to see how R&D MedTech utilizes PrimeExchange to accomplish this important activity.
Big bang vs. phased implementation. Should all physicians go on the system at once? Should you start all functions at once? Ideally, all physicians in one office should go on the EHR together. Otherwise, the office staff will need to run at least two different sets of processes for paper-based physicians vs. EHR physicians. Not only is that confusing, but it also is inefficient.
However, if your practice has more than one office, there is no overriding reason that all practices have to go on the EHR at one time. In fact, depending on your practice's resources, you might be wiser to roll out one office at a time.
A few practices have successfully implemented all functions of an EHR at once. This can be called "big bang." The consensus, however, is that success is more likely if you implement functions sequentially in what is known as "phased implementation."
R&D MedTech works with each client practice to formulate the implementation that makes the most sense to that practice.
Training. We can facilitate your training at our headquarters, at an off-site location close to your practice, or in your own office practice environment. The Go-Live deployment training is always conducted on-site at your practice. When comparing our solution to our competitor's, this is an important differentiator as the success of on-site training implementation is much higher than the web-based training solutions offered by our competitors.
Tailored Instruction: To make the transition to EHR as easy as possible, following the training and go-live phases, we provide client specific and tailored instructions for each job function. This resource is a valuable guide each member in the practice becomes familiar with the EHR system. This includes everything from accounts receivable monitoring to physician specialty template customization.
Onsite Training: When practices look to "Go electronic", they reach for their most common real-life experiences to guide them, cognitively, about "What is this going to take?": For most people, that's installing some software on their computer.
The problem is, this experience is a poor model to understand EHR implementation:
1. It implies “This is something you can do with an instruction book and maybe a little help”.
2. It implies “This is something that is experienced at the computer, and the computer only.”
3. It implies “It generally takes a week or two to 'get really good' at it.”
What it misses is:
1. EHR implementation means a THOROUGH examination of all of your clinical workflows and then in some cases, reorganizing them under a new electronic paradigm.
2. “Support” is NOT an instruction book, and NOT a 2-hour class, but a continuous, ongoing monitoring of physician, nurse, and practice management behaviors - And to achieve this requires an entire support mechanism of its own.
3. The 'learning curve' is often longer than anticipated.
R&D MedTech believes there is a higher probability for a successful implementation if training is delivered in person as opposed to over the web or from a CD. Our trainers are certified by Greenway after intensive classroom and shadowing experiences.
Note design. R&D MedTech will train users on the thousands of standard Greenway Primesuite note templates that span over thirty specialties and subspecialties. However, given the variation in how physicians practice medicine, you will most likely decide to utilize the ability to easily customize these templates in the Greenway software to suit your practice style. Some practices develop dozens, even hundreds, of templates for use in a wide variety of clinical situations.
However, you'll need to consider how much leeway each physician should have on customized templates. For example, should your practice design one common template for the medical group on diabetes? Or would it work better if you allowed each physician or practice site to create a customized variation? If you are using a template for the purpose of disease management, then it makes sense to standardize. Otherwise, allowing individual variations will likely promote higher EHR utilization and efficiency among your physicians. R&D MedTech can assist with this process, because once your physicians and practice manager have attended our template modification course, they can perform this activity with little or no outside assistance because Greenway functionality is very user friendly.
Going live. After extensive preparation, turning your system on, or "going live," should be uneventful. Given that Mondays are your busiest days, they are a bad choice for a "go live" day. Pick any other day. Make sure your physicians have lighter-than-normal schedules - ideally about a 50-percent workload. Most practices do this for the first two weeks and then resume normal schedules. This will vary depending on your implementation's design. R&D MedTech works with your practice's management team to coordinate the schedule that works best for you.
Support. Adequate vendor support is essential for success. R&D MedTech will respond to your calls for help quickly as part of its guarantee. In fact, we track our help desk response times and numbers of outstanding "help tickets" for each practice and can provide you with those reports if you are interested. Both R&D MedTech's and Greenway's track record for customer support is ranked high in customer satisfaction as evidenced by our help desk tracking and KLAS ranking in this area. This speaks to the importance of thoroughly investigating your vendor and the product before you sign the contract.
For more information on R&D MedTech’s philosophy of service to our client practices, please call 918-682-2285.