I saw a really good article written by EHR Insider that had a great idea in evaluating EMR companies. You should know and understand how much time and effort it will take to implement the EMR. Demo’s are usually on systems that have been set up extensively and designed to show you the best features. Knowing what effort it takes to get to that point is important. I would suggest that his request of what to configure seems to focus on how one company implements EMR. I’d prefer something more generic. Possibly a description of what you do now and how they suggest you implement your current process in their EMR environment.
Enjoy the article:
Tip #1, from EHRInsider.com…. Request a Configuration Demo!
Whats a configuration demo? Well… I just made up the term, but what I mean is that you need to schedule more than a features demo (thats when you have the rep shows you all the great things an EHR can do). You also need to have the rep provide a second presentation, the configuration demo. This demo shows you what it takes to build or setup the new EHR.
This is likely to just be for your smaller group of people who will be setting up the EHR during the configuration phase. When you buy an EHR you will typically create a small group comprised of a nurse, a provider and your new EHR administrator(s) and this group will be responsible for setting up the EHR prior to your on-site user training and Go Live date many months down the road. This group of people simply must get a good idea on what level of computer expertise and how many man-hours are required to setup and configure this new system, and keep it running once its live.
This is the most shocking mistake I see. People are clearly buying $100,000+ systems and dont have any idea about what it takes to build a new progress note template. Or create a new lab panel, a message template, a flow chart or add/modify new EHR screens. How hard is it to have the lab results drop automatically into your progress note? Or to change a health maintenance items due date? And your group will have to do all of this and much more before you take the system live.
One of the most time consuming aspects of setting up your new EHR revolves around building and modifying the progress note templates. You have to have this demonstrated to you, as you are the one who is going to actually sit there for months and work on them.
In some systems this is easy, in others, it can be very intense. I can guarantee you that there are some EHR reps who will absolutely wilt if you request this. Its the last thing some of them want to discuss and they will provide every excuse for not being able to show this. (Im too new; thats our trainers job; we dont have that module here today). So, my second tip is to make it clear when you schedule the initial features demo that you “may” also want to have this configuration demo as well. (It should happen after the features demo of course, as you might not even like what you see there so you won’t need to complete the config demo).
Below is how I educate clinics on how to do this. Have them build a NEW progress note template (because sometimes its hard to build a new one but easy to modify an existing one). Start with a blank screen/design template and ask them to put in things that are downright silly; things that you know cannot possibly pre-exist in the sales reps demo set. I would suggest something like this:
Dear sales rep. Please build us a new progress note template. Create a new prompt that asks, What type of berries were you eating. Then create a pick list for that prompt that contains 3 common answers to this question, such as square berries, polka dot berries and striped berries. If you would select stripped berries, have that answer tree off and provide two more questions, such as, what size of berry and how many did you eat. Ask to see how you can allow for free text entries for any of these answers. How do you get E & M coding credit for asking it? Ask how to make one of these questions a required field, i.e.; the provider must answer this question prior to signing the note. Ask to see how the new template can drop in the patients name, sex, age, overdue health maintenance items, their problem list, med list, allergies, past/social/family histories and their last Lipid Panel results. See if you can put a hyperlink in that template that will snap you to your favorite web site or to some patient education form. Can the template contain reminders to you (the provider) about things to consider about berry eating that will automatically delete once you sign the note? Ask how you would create a text macro for many of the things that you often say and see how easy it is to drop that macro into any note. You can also ask to see how to just modify existing templates, to add or delete or re-arrange questions and text macros.
For most providers its all about the progress note with an EHR. Most of the rest of the system is easy enough to use and learn. But a poorly designed progress note editor can shock the doc and you may likely end up with a lot of providers not using templates like your ROI plan assumed.
At EHRInsider we hope to help a lot of clinics avoid common implementation problems by providing insider knowledge to your EHR search.
If anyone would like more information about our new company that helps clinics avoid the common pitfalls with an EHR, please visit us at EHRInsider.com.
Thank you Dr. Murdoch, and good luck everyone!