There is about a 50 percent failure rate for <a href="/directory/electronic-medical-record-emr" target="_blank" class="directory-item-link"><a href="/directory/electronic-medical-record-emr" target="_blank" class="directory-item-link">electronic medical record implementations, and most of those failures stem from poor planning and preparation, said a family physician who spoke at a regional extension center (REC) forum held for providers in Maine.

Scott Patch, MD, practices in Yarmouth, Maine, and is part of a multi-specialty medical group called InterMed P.A., which has been using an EMR for about five years and is considered a “paperless” environment.

Patch says when a practice is considering moving to an EMR the whole organization has to “buy-in.” In other words, everyone has to be onboard –  even staff at check out. There is a “redistribution of work” said Patch. "There is going to be more and new work. For us it was our check out staff that required more training,

The hardest part is maintaining good communication, said Patch. That is why it is important to identify a plan and choose a physician champion. “There is nothing more powerful” than choosing another doctor for this role, as doctors tend to listen to other doctors, he said.

Part of an EMR plan is assessing what your practice does and doesn’t do well, said Patch. “The EHR represents a fundamental change to the way the office handles the movement of patients and information,” he added.

This is where document management comes in. “Scanning is not the answer to everything,” said Patch, noting that “preloading is more important for productivity; if you favor preloading it is much more efficient down the road.”

Preloading, he explained, is having someone enter key data about the patient’s medical history, like medications, allergies and immunizations, into their chart before an appointment. Patch said it's helpful to determine beforehand a list of items that are important to preload. For his practice it's a list of ten. If a doctor has to go back to a paper chart to find something, then the chances that they are going to use the electronic one are slim, he said.

“If you are scanning, remember structured data,” Patch also advised. “Capturing structured data is the most important part of the EMR.” Any data for which you can generate a report is important for reimbursement and patient tracking, he said -- this is why standardization is a key benefit of implementation, and why having the lab interface with your EMR is important. 

Finally, Patch said to be prepared for the EMR transition to take months, not weeks, and to make sure to listen to the feedback of your staff and have a good relationship with your vendor.

The session was part of regional forum series being held by The Maine Regional Extension Center (MEREC), overseen by HealthInfoNet, and Quality Counts, a regional healthcare collaborative committed to improving health and healthcare for the people of Maine.