Moen said they needed to do a lot of testing before they went live. It was the, “small things like a period that didn’t get carried over in a name that changed how you found that person in the system,” that presented the most difficulties for the practices she said.

The next step for the NMN was a three-phased EMR implementation with Sawtooth Mountain Clinic going live in April 2008 and then Migrant Health Service following in June and Scenic River Health Services in September (its last site was expected to go live on Oct. 21).

“Training was very important and something that we needed a lot of,” Moen said. The clinics also had to cut back on productivity and the staff put in long hours, she added.

Nancy Mault, EMR coordinator at Scenic Rivers Health Services, said a “pain” she witnessed and experienced during implementation was “providing patient care while trying to implement a new electronic medical record.”

Paul Terrill, MD, Sawtooth Mountain Clinic’s medical director and family medicine physician, agreed. “The hardest thing for the providers to learn is how to conduct a visit in electronic format,” he said. “We are in a transition phase right now. We are totally transforming the visit process and how nurses and providers do their work. We tell them that they will never see a transition as large as this in their careers.”