Success with EMR System Adoption

As technology becomes increasingly sophisticated and targeted for healthcare workers, more and more practices are making the decision to adopt an electronic medical record (EMR) system. And it is no wonder: properly designed EMR systems eliminate the need to transcribe notes on paper and can potentially streamline physician workflows. Time saved from transcription can be spent with patients to better explain diagnoses, treatments and ideal outcomes.

That said, reaping the benefits of an EMR system takes more than simply implementing it: having a good relationship with your EMR vendor is key. While there are certain aspects to keep in mind throughout the spectrum, a healthy relationship includes 2 main qualities:

  • A strategic partnership in which both the practice and the vendor commit to building and maintaining a long-term relationship.
  • A mutual understanding of processes and expectations that is set through open, concise and timely communications.

Whether a practice is still looking for the right system, is in the beginning stages of implementation or considers itself an EMR system pro and is switching to a new vendor, there are key steps every practice must take to operate efficiently with a system.

Before You Purchase

For practices in the EMR system selection phase, the key is to know your needs ahead of time so you can ask prospective vendors the right questions. Along with basic questions like how much the system costs, 3 questions practitioners should ask include:

1. Is the system client-server or cloud-based? Client-server systems are installed locally on hard drives in workstation computers or office laptops. They tend to require significant data storage and backup infrastructure with costly servers and information technology support. Data may be accessible with remote login systems, although not necessarily on mobile devices, so you have to be physically at the office to access patient records.

Cloud systems generally require less technical infrastructure and capital outlay and may allow greater mobility of access to records for the doctor and office staff. With a cloud-based system your patients’ records are accessibly almost anywhere, anytime.

2. Does the software support interface with practice management (PM) software? Some vendors offer “all-in-one” packages that include PM, billing, inventory, marketing and EMR systems, while others are designed to interface with a variety of other PM systems to allow the users to “mix-and-match” tools that may better suit the practice’s workflow.

3. Will the system automatically generate billing codes? EMR systems should help your staff reduce workload by automatically generating evaluation and management and CPT codes, as well as ICD-9 (and eventually ICD-10) codes, to maximize reimbursement. Be sure to ask the vendor’s strategy for implementing ICD-10, as the more than 100,000 new codes can potentially impact your practice’s productivity and bottom line in a significant way. 

Ask questions. It does not matter what features an EMR system comes with unless they complement your needs. Identifying what those needs are and asking questions that relate to them before implementation will ensure your practice is on the right track.

As You Implement

While the amount of time it takes to transition to an EMR system is unique to each situation, it typically takes at least 6 to 12 weeks to be fully operational with a new system. During this transition, your practice should study the software and its functionality so there are not as many questions once the system is in place full-time. Do this by:

  • Taking advantage of training options. Many vendors offer in-person or online training options for different lengths of time. These training options are especially useful for practices that are new to EMR systems, but even if your practice has used EMR software in the past, they can still be worthwhile because every system has unique capabilities. And remember, physicians are not the only ones who need to understand how the EMR system operates. The entire office should participate in training, as EMR systems closely relate to other practice needs, like billing. And do not forget that a vital aspect of training is practice — ideally well in advance of your go-live date.
  • Easing into it. Overwhelming the office with new technology will do more harm than good. By gradually making the transition to a new EMR system, staff is less likely to become frustrated with the new technology, making it more likely that the practice will not switch systems in the future. One way a practice can ease into the transition is by identifying a few patients each day that will have their notes duplicated into the system after completing them with the existing approach. For example, if you are currently using paper charts, perform all of your usual charting for the entire day and then, at the end of the day, attempt to recreate a few notes with the same clinical content that would serve the same documentation purpose within the EMR system.
  • Developing a process and communication plan. Have a plan for how you are going to process documents and pathology reports as well as sensitive information. Find out if your EMR system has a dedicated internal communication tool, then set clear guidelines for what types of information can and should be shared internally through the record system. Once you have a process plan in place, determine your strategy for how communications will be conducted with patients. To what extent will you use patient engagement tools, and how will correspondence be memorialized in your records?

After You Are a Pro

Once your practice feels comfortable using the new EMR software, the work does not stop. Just as medicine is constantly evolving, so are the rules and regulations that determine how medicine is practiced. Therefore, it is important to keep abreast of new rules that affect Health Insurance Portability and Accountability Act (HIPAA) regulations and compliance programs. 

Developers continue to create technologies that make it easier to communicate from doctor to doctor, doctor to patient or from machine to machine. While this results in a more mobile and efficient practice, it also means that it is easier for physicians to unknowingly compromise patients’ information. Penalties for HIPAA breaches can be substantial, so it is important for practices to understand how to use electronic tools in ways that do not compromise protected health information.

In addition, because government compliance programs such as Physicians Quality Reporting System and Meaningful Use are constantly evolving, ensure that your practice takes advantage of your EMR vendor’s educational programming to keep up with the latest changes so you can utilize your system to its fullest extent.

This may seem like a lot to keep track of, but by breaking implementation down into the phases described in this article, any practice is capable of mastering new EMR software. If it is not clear by now, the key to working efficiently with new technologies is research, education and a healthy relationship with your EMR vendor. If you invest time in examining your practice’s needs, how your chosen EMR system operates and working closely with your vendor, you will have no problem making the most of what the system has to offer. 


Dr. Sherling is the co-founder and chief medical officer of Modernizing Medicine. He is responsible for developing and designing the dermatology-based software, and supervising the design of Modernizing Medicine’s other EMA Specialties.