Who Are You Leaving Out Of Your EMR Plans?

As any reader of this blog knows, it takes a lot of consensus building to successfully implement an EMR, whether you’re rolling it out across a large health system or within a small medical practice.

The thing is, I get the sense that many of the day-to-day staffers who will have to live with the EMR system aren’t consulted during the acquisition process, or only at best, only get to participate late in the game.

I’ll remind readers up front that I’m a journalist, not an EMR consultant, but from what I’ve seen, the following healthcare professionals seldom get much input into EMR decision-making:

– Front-line nurses

– Nurse managers

– Billing managers

– Coding professionals

– Medical practice managers

– Day-to-day IT support staff

– Medical assistants

While admittedly, some of these players play a more central role in patient care than others, they all have a window into what the EMR should deliver.  And if you asked them to review the vendor demo, examine the features and pose some questions, they might find issues that you hadn’t anticipated.

They might also note process problems that you weren’t aware of which, even if they can’t be solved by the EMR itself, may never come up for discussion during the normal course of business.

All told, my sense is that if a hospital or medical practice circulated questionnaires asking a broad range of staffers what the EMR should do, and what’s not working in the current environment, they’d make better decisions and learn a lot about their organizations along the way.

Unfortunately, I doubt this will happen much, as healthcare is still lamentably hierarchical and riddled with inefficient top-down decision making. But hey, the idea’s worth a mention…

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.


  • I agree, implementation of an EMR often doesn’t include all the parties who should be at the table. I wouldn’t suggest a survey. I would suggeset starting with the following questions:
    1. Who will enter the data?
    2. Who will use the data for patient care delivery purposes?
    3. Who will review the data for quality, billing or other business related purposes?
    All of these parties should be at the table seeing the changes that are coming and being provided with an opportunity to talk about how the system will impact their job. to discuss current work arounds that won’t be possible with automation and to help design the go forward solution.

  • John, a couple of observations about your list, and the issue of input, especially for medical groups/physician practices.
    1) Input from a variety of sources, especially “primary” users, such as physicians and nurses/MAs, and “secondary” users, such as billers and coders, is important. But sometimes, before such input can be obtained, staff members and managers must be educated about what the new system will look and feel like to use. Otherwise, staff may simply keep trying to apply existing thinking about processes to a new system, instead of conceptualizing entirely new ways of doing things. Vendor demos are a good way to get people thinking, but so are workpractice evaluations and process flow charts.
    2) The flip side of not enough input is too much, that is, turning the evaluation and implementation process over to the billing staff, which uses its own set of criteria based on billing and collections.

    The final decision may come down to which system the physicians may estimate will be easiest to use, which is very important. But broad-based input should help the decision-makers reach a conclusion that will work for all parts of the organization.

  • First and foremost ask your hospital pharmacist team to look at the order entry piece. They’ve been entering orders into computers for 15+ yrs now. This will eliminate 90% of your CPOE implementation failures. Then bring in nurse clinicians with providers, hopefully in one room. But keep pharmacists around throughout – you’ll thank me later.

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