EMR Implementation Training

One of the things that always surprised me was the level, or lack thereof, of basic computer skills that existed within most providers’ offices. This low level of computer skills existed not only with office personnel, but also with doctors and nurses. Therefore, when implementing new computer software a lot of time was spent providing basic computer training in addition to software specific training.

With EMR implementation it’s highly critical that both medical and office personnel are trained on EMR systems. If they are not properly trained they will become frustrated, and possibly, unproductive. An unproductive doctor and/or nurse in a clinical setting is not a good thing. If that happens it could sabotaged the best of EMR implementation projects.

Keep in mind that no two providers are alike and work flow processes differ from one provider to another, here are a couple of training recommendations when providing EMR training that are applicable across the board. First, access the computer skills of everyone that will be using the new system. If basic computer training is needed, include it in your training curriculum. When providing basic computer training take nothing for granted, heck, you may have to teach keyboarding, how to operate a mouse, etc., just be prepared to get the users up to speed on the most basic of computer skills. Secondly, provide one-on-one training when feasibly possible. I found one-on-one training works best for this set of users, especially for smaller to medium sized providers. If this is not possible, try to have at least one experienced (or a well-trained user) to support every two doctors during the initial days of “go live.” And thirdly, require ALL medical personnel to attend training, even if it means night and/or weekend training sessions. This may require flexibility on your part to accommodate everyone’s schedule, but it will be time well spent to have trained doctors/nurses using the system on day one of “go live” versus doctors/nurses doing OJT on the day of “go live”...

Remember the best way to eat an elephant is one bite at a time, so save yourself a headache by implementing EMR in phases. Implement only one process at a time before turning up the next process. Because if glitches are caused by implementing an EMR system, i.e. billing, clinical, prescriptions, etc., the emergency system just may get activated (see cartoon)...

EMR Costs, Just Like Hens in a Hen House

On the heels of my last post, EMR APP for iPhone, I mentioned the cost of the EMR iPhone app was less than $200. Keep in mind EMR deployments can cost millions. In a report by the Free Library, “EMR: one hospital that got it right,” Dr. James Leo, associate chief medical officer for Long Beach (Calif.) Memorial, stated "EMR [systems] can cost hospitals $20 million to $200 million due to implementation, vendor and hardware costs, staff training, and upkeep." Smaller providers’ can expect to spend from $25,000 to $60,000 per physician to deploy an EMR system. For smaller providers this projected cost doesn't cover consulting, training, add-on-software, and upkeep.

Despite the availability of EMR iPhone apps, EMR deployment is still a costly project. For this reason, a good case can be made for EMR implementations to hire an external EMR consultant, which is not employed by the vendor, is money well spent. Go ahead, laugh. Coming from an IT professional, this is like the rooster telling the farmer he needs more chickens in the hen house, right? But for a project of this magnitude, whether it’s for a small provider’s practice or a large hospital institution, having someone on board that’s not affiliated with the vendor but has rolled out one of these systems is money well spent.

Just like the farmer will be ecstatic with the additional hens in the hen house once all of his hens are producing more eggs, providers will be happy that a set of non-partisan eyes are part of the project team when implementation challenges are encountered. As IT professionals, we know that implementation challenges will be ecountered.

Click here to read the entire article from Free Library.

EMR App for the iPhone

In a previous blog entry, “A Gadget Kind of Day” I blogged about Sling Box finally releasing the Sling Player Mobile app for the iPhone and iPod Touch. Because of my excitement to finally get a chance to watch TV on my iPod Touch, I proudly stated the blog entry had nothing do with HIT, other than possibly up selling a techno-geek physician that had to have the latest gadget. Thanks to blogger Fred Pennic of Healthcare IT Consultant Blog for his blog post on an EHR app for the iPhone.



A company in California, Caretools, have developed an award winning app, iChart, specifically designed for the iPhone and iPod Touch platforms. In addition to the charting, iChart also includes prescription, billing and lab report modules. Basically, all patient data is entered on the iPhone app, or from a web based desktop computer. Once new information is added to a patient’s record via the iPhone, the data is first stored on the iPhone and then synchronized to an iChart Web based account.

So in a nutshell, iChart is a SaaS EMR with an iPhone front-end. Therefore, the same risks identified when evaluating a SaaS EMR must be taken into consideration when evaluating this app. Also, because patient data is stored on the iPhone, in order for this app to be HIPAA compliant the dreaded iPhone password must be enabled. Honestly, do you know anyone with an iPhone that has their password enabled? However from a price standpoint, Cartetools have competitively priced the iChart app. The basic product is priced at $139.00 for the first year with an annual renewal subscription fee of $99.

Here again, for the techno-geek type provider, this app can’t miss, its way cool!! For the bread and butter type provider, a desktop anchored down in the examination room or a nice size handheld tablet is more in line.

Click here to visit Caretools' website.

Read Fred Pennic’s complete blog article here.

Healthcare Reform Noise

Since there is so much noise in the system about the troubled waters President Obama’s overall Healthcare reform package is facing, let’s not forget that Healthcare IT reform is still on pace. The previously approved federal stimulus package included about 10 billion dollars in net Medicare and Medicaid incentives for EHR adoption.

In a recent interview, the National Coordinator for Health IT, David Blumenthal, discussed timetables for electronic health record adoption with American Medical News. Blumenthal said officials are still promoting EHR adoption in an effort to meet the President’s goal of providing all U.S. residents with an EHR by 2014. He also added that his office is still working under the guidelines of the federal economic stimulus law, which imposes penalties on health care providers who do not adopt health IT tools by 2015. However, Blumenthal acknowledged the challenges facing his office and physicians to make this happen but he believes his office and the physicians are up to meeting the challenge.

EHR adoption is alive and well, so now is not the time to let up on pushing EHR solutions. When presenting to clients and the user community it’s imperative that IT professionals deliver a clear and concise message that the current noise in the system does not affect the federal requirement for EHR adoption by 2015.

Read the complete American Medical News article here.