WASHINGTON - Implementing an electronic medical records system is a logistical challenge for any practice, but specialty practices often have unique needs – and face distinctive barriers – that need to be considered before an EMR purchase can be made.

An important step was recently taken to address those needs. The Certification Commission for Healthcare Information Technology announced in late November 2006 that it would expand its certification of ambulatory EMR products to address medical specialties and specialized care settings. CCHIT collected environmental scans until January 12, 2007, to help determine which specialties would be included in the expanded criteria.

Some specialty-specific EMR concerns were debated during a panel session at last fall’s Medical Group Management Association Annual Conference in Las Vegas. Administrators from three gastroenterology practices spoke about their experiences transitioning from paper to electronic medical records and gave other practice managers – and vendors – insight into the challenges a specialty practice faces during EMR implementation.

Scott Johnson, practice administrator at Digestive Disease Associates of Gainesville, Fla., said customization of an EMR at a specialty practice takes significantly more time than product vendors suggest.

“Don’t expect to reduce staff time in the first 12 to 18 months after adopting an EMR,” he said. “You have to be ready for changes in your workflow, and good communication is absolutely necessary for success.”

Despite his caveats, Johnson made clear that the benefits of going electronic outweighed the frustrations. He said his practice saves more than $150,000 annually on chart pulls alone, and the practice’s physicians have gained 60 to 90 minutes per day in available work time.

“The greatest success of our EMR transition is chart access,” he said. “But we’ve also improved the messaging system and reduced patient wait times. It’s been good for the entire clinic.”

Quick and easy access to patient charts is the “first and biggest benefit” of an EMR, agreed Peter Donaldson, administrator at Digestive Health Specialists of Winston-Salem, N.C. He added, however, that one of the particular benefits an EMR offers to a specialty practice is easing communication with referring physicians.

“We can transmit patient reports to the referring physicians as soon as they’re written, and that often happens before the patient leaves the office” he said.

Donaldson agreed that the EMR implementation process takes longer than advertised. He said specialty practices should expect to spend three to four hours per day dealing with EMR-specific issues for at least six months.

Nevertheless, he wouldn’t go back to paper.

“We have increased productivity 40 percent with no additional staff and we’ve experienced a 22-percent increase in profitability in four years,” Donaldson said. “The change has been a struggle but it’s yielded big benefits.”

Kathy Sammis, administrator at Charlotte (N.C.) Gastroenterology & Hepatology, encourage her colleagues to be flexible in dealing with reluctant providers at their practices, with the expectation that an EMR implementation schedule would change to meet the needs of doctors.

“Some physicians aren’t computer-savvy, and you need to provide continual support if you’re going to get them to accept the change,” she said. “We’re a large multi-site practice with an IT manager and two trainers, and even we didn’t spend enough time walking the physicians through this.”

CCHIT plans to release a final roadmap for expanded EMR certification criteria March 12. The public comment period on CCHIT’s draft roadmap will be February 1-28.