How to Prepare for EMR Implementation

1. How to Prepare for EMR Implementation Ambulatory Electronic Medical Record Rebecca Hemphill, MD Greater Portland Medical Group Karen O. Andrei MH Ambulatory Team

2. Goals for Today • Discuss Initial Steps – Establishing project Leadership • Brief Review of some Operational Redesign Issues • Review of Preload • Lessons from Experience

3. Establish Project Leadership • Team Approach/Team Effort • Physician • Clinical Support • Medical Records • Administrative • Identify Leaders • Physician & Project Champion Doesn’t need to be technical, more important that they are involved, respected, able to support others, able to make decisions for the group

4. Operational Redesign • Assess current workflow • plan how it will fit into an electronic process • Standardization as it applies to all processes • Patient flow • Messaging • Prescriptions • Orders • Documentation • Scheduling

5. Planning for Preload • Abstraction • Problem List • Medications • Allergies • Vitals • Labs (Lipids, fasting Glucose, TSH) • Immunizations: as appropriate • Last occurrence of Health Care Maintenance data • Last mammo, colonoscopy, pap, PSA, lead screening • Prepare your charts in advance with plans in mind tomanually abstract data. (Regardless of when you go live, prepare now!) • Prepare your PM system by identifying and merging duplicate patient records, ensuring clean and accurate demographic information for interfacing. • The amount and duration of preload will depend on abstraction decisions and ability to automatically preload data from legacy systems.

6. Scanning • Limit what you scan: you can pull the paper chart later • Consider minimum required to treat patient • Helpful documents • Last consultation note(s) • EKG • Growth Chart ----or consider abstraction of height and weight to utilize the functionality of the EMR to automatically generate a growth chart • Radiology Reports

7. Comparing Preload Options

8. Other Considerations • Hardware – plan the budget now! • Review the physical layout of the practice and exam rooms • Plan practice schedule • All staff present during go-live • Plan vacations before and after implementation

9. Lessons Learned Learn how to use the EMR to support and enhance your conversation with patients. Understand that patients will mirror your reaction Will not save time……initially Have realistic expectations, the transition is difficult, but the difficulty will pass Communication is critical for learning and growth A year from go-live users would never go back

10. Benefits of Implementing an EMR • Prescription refill • Medication reconciliation • Immunization record for summer camp • Referrals • Pay for performance reporting • Analysis, trends • Patient education, instructions • Improved legibility • Drug recalls....... to name a few

11. Implementation Milestones

12. ImplementationTeam Project Mgrs Training Practice Readiness Implementation Analysts Interface Database Admin Hardware Epic Support Consultants

13. Brochure For more information specific to the MH AEMR Implementation go to: http://mhaemr.mainehealth.org