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Leadership Tips For EHR Implementation

In a study entitled, “Adoption of Electronic Medical Records in Family Practice: The Providers’ Perspective,” Amanda L. Terry, PhD, studied six primary care providers in Canada and found that the leadership role is crucial for success in implementing an EHR platform.

The final sample was comprised of 30 participants from six practice sites (three urban, two rural, and one small-town practice). Participants included 13 family physicians, 11 other health professionals (including nurses, Medical Assistants) and six administrative staff (receptionists, secretaries).

In-house problem-solvers emerged during the EHR implementation and adoption process. These individuals played an important role in addressing day-to-day issues related to the EHR. Their function appeared to be more hands-on, in contrast to physician “champions,” who typically assumed more of a leadership role in EHR implementation.

Both roles are seen as important and need to be encouraged. Both the in-house problem-solver and the champion serve a key role in helping users move forward throughout an EHR adoption.

Here are additional leadership tips for EHR implementation:

Make it your number one priority. Although you may be tempted to conduct business as usual and continue with your normal patient load, it is necessary to devote a substantial amount of time for analysis, system set-up and configurations, status meetings, user training and management of that training. Lead the change. Set practice strategy and direction, communicate goals and priorities, assign tasks and ensure adequate completion of those tasks to achieve the desired ends.

Communicate early and frequently in order to set the tone for the importance of the project to the practice staff.

Lay out the projected steps for the project and the overall vision. Set the strategic vision, setting forth all of your expectations so that your practice understands where the practice is headed in terms of increasing efficiency and quality. If your staff knows what to anticipate, you will have a more successful implementation.

Don’t delegate leadership. If you delegate leadership to staff members who are accustomed to using a previous EMR system, there is a tendency that they will focus on what the practice has been doing all along, instead of concentrating on the benefits of the new EMR. They may not embrace the big picture because they are connected to the older workflow and feel comfortable having already mastered the older systems’ functions.

Don’t neglect training. Commit the necessary time for setup and training before and after the implementation. Training by clinical and billing experts before and after the go-live date greatly improves adoption success.

Don’t go back to the old ways. In Kurt Lewin’s Change Model, the final step of the change process is refreezing. This is where the new structure and processes are accepted as the new norm going forward. The changes put in place during implementation must be cemented in the organization or there is a risk that people will revert to the old way of doing things.

Homer L. Chin, M.D., MS, is the Assistant Regional Medical Director for Clinical Information Systems for the Kaiser Permanente Northwest Region and Assistant Professor in Medical Informatics and Clinical Epidemiology at the Oregon Health and Sciences University. Kaiser Permanente Northwest (KPNW) has more than a decade of experience working with EMR implementations. Dr. Chin explains why it is so dangerous to base an implementation on the way things have been conducted in the past.

“The EMR is the ‘great magnifier.’ If an organization already does something very well, then the implementation of information technology will probably further improve its performance in that area. However, if an organization is dysfunctional in an area, then the implementation of an EMR will probably magnify that dysfunction. Identifying and addressing potential areas of organizational dysfunction prior to implementing the EMR may improve the overall results of EMR implementation.”