#ImplementationEHR in stages, #inthetrenches

Transitioning from the paper world to an EHR is certainly not for the faint of heart, and the first 3-6 months, the most difficult, but ear buds and Pandora make it a bit more tolerable.

My recommendation is the doc should do all his own data transfer, and I will walk you through what this entailed.  I was pseudo-electronic and had my records on Microsoft Word, so could copy and paste the Past Medical history, but had to dictate with Medical Dragon or type the social, family, and allergy list.   Medications being codified, had to be typed individually, and diagnosis codes manually entered. I would prepare my charts a week in advance, and the average chart would take 10-15 minutes, but at that point I was able to tidy up charts, some 19 years old.

By month 6, most of the 3-4’ers, multiple charts for complex frequent flyers, were integrated,and a significant improvement in efficiency occurred.  So the first stage is data entry, painful but necessary,and helpful if done by the doc.

The second stage is initiating e-prescribing in the first month, and once started one will wonder why or how he did without.

By month 6, one should start importing laboratory results directly into the EHR so the HL7 feature can be utilized.

Then by 6-8 months one should initiate the e-faxing with a product like Updox, and by month 12 the secure portal implementation initiated.

So, gradual transition in stages, is my recommendation, but picking the right substrate, the EHR, is critical and not unlike getting married, and if you can get it right the first time, will reduce pain down the road.


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