“Carmon, this is Dr. X.  I started using this new system yesterday and it’s just not working for me.”

Now I have a thousand thoughts going through my head, but I try to continue the conversation to find out exactly what’s “not working.” 

I soon realized exactly where this doctor was.  He was in the same place that many doctors find themselves when they begin using an EHR system --somewhere on the “uphill-side” of the learning curve.  This is not unusual during EHR implementation.  At my company, we work with doctors every day, discussing EHR implementation and the advantages of these systems.  These two issues are big areas of concern for providers considering EHR systems.  So, what are the answers to these questions?  1.  What does it take to implement an EHR system? and 2. Why should I purchase an EHR?

First EHR implementation:  These are complex systems that affect your day-to-day clinical work.  They can’t be installed in a day.  It’s a project that typically stretches over several weeks.  In order get this done smoothly; you need a project manager.  It is also a tremendous advantage if the people doing the managing and training are local system experts.  A local team is more accessible, more flexible with their time, and can be available on a schedule that more closely matches yours than an organization coming in to town for a few days to cram in some training.   Also, it is imperative that both doctors and staff be committed to the project.  Your enthusiastic leadership is critical  to success.   

We’ve also found that these projects go best in doses.   It’s simply impossible for anyone to begin using the entire system day one; you just won’t have the foundation of knowledge necessary to put all the pieces together.  Learning the software in smaller doses will allow you to master the system one or two parts at a time.  That’s also why it makes sense to have a local team leading the project.  They are able to schedule your training sessions this way; a company a thousand miles away just can’t do this, and if it did, their travel expenses (which you are responsible for) would go through the roof.

Why should you purchase an EHR?  Well, I’m not certain you should.  There are many personal decisions to be considered here..  Those are up to you, I can’t address them.  But, here is one thing I do know: you need to make a decision very soon!  Whether it’s yes or no, you should decide now, and here’s why.  PENALTIES.  We are two years into the American Recovery and Reinvestment Act (Stimulus) program that spelled out the incentives and the penalties for physicians adopting  EHR.  The incentives: $44k for Medicare and $62,750 for Medicaid.  Yes, it is still possible to get all that money.  (We have many providers who have received their checks…the money is real.) 

But the penalties are real too.  If you decide not to adopt an EHR you WILL be penalized beginning in 2015.  DO NOT wait until 2014 to decide on EHR.  Why?  First, the incentive money for adoption will be gone and second, you will be under the gun to get your system installed just to avoid the penalties.  This is a recipe for disaster.  Don’t put yourself and your business in that situation.  Make your decision and move forward.   Procrastinate and it could be a real mess. 

Oh, Dr. X, and the 7 am phone call:  we scheduled a couple of extra sessions with him to fine tune his progress note.  30 days later, he called back. 

He was thrilled and wouldn’t dream of going back to paper  charts.  He has since attested to his Meaningful Use of an EHR and received his first payments…it can be done! 

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