Changing to an electronic system of medical records can provide many long-term benefits, but it can cause a few headaches upfront. Once you've fully implemented your electronic medical records (EMR), you can breathe a little easier. Many of the growing pains and major changes in workflow will be behind you, but managing and maintaining your system will remain an active process.
Knowing what you need to stay on top of the process and having plans in place to address concerns can help keep your office running smoothly as you adapt to the ever-changing health care IT environment. The most common areas of focus after implementation are security, IT support, and optimization.
Keeping Protected Health Information Secure
Securing patient information is a top concern for anyone using EMR. In a recent Healthcare Information and Management Systems Society (HIMSS) survey, 20 percent of respondents said that their organization had experienced a security breach in the past year. In an office environment, it's imperative to have proper training for all staff on security procedures and a written policy regarding privacy and security.
It's critical to regularly review the permissions granted to all staff members to ensure that only the right people have access to the information, either through role-based controls or an access-control list. Other simple ways to protect patient information are to frequently change passwords and to set the system up to automatically log out after a set time of inactivity.
Appropriate IT Support
As with any software system, your EMR will have regular updates that may change certain screen views or processes. Having appropriate IT support, whether in house or through your EMR vendor, is critical to adjusting to the changes without any interruption in your office workflow.
Be sure that you have a clear line of communication with support staff or trained personnel in the office who know the EMR system well. Having a clear plan for communicating any downtimes for maintenance or updates will help ensure smooth operations as well.
Optimizing the System and Sharing Health Information
Physicians play an important role in the optimization of EMR, particularly as part of a larger health system. In the HIMSS survey, about 20 percent of respondents said that their primary clinical focus was on physician systems, including clinical-decision support solutions, computerized physician order entry, and physician documentation.
Optimization involves improving workflow and ensuring that the system meets the needs of your practice. Look at what's working, what can be done better, and what you want the system to do next. The Office of the National Coordinator for Health Information Technology (ONC) offers guidance for developing an optimization strategy through continuous quality improvement. Continuous quality improvement is a philosophy that encourages organizations to continually evaluate how they are doing and how to be more effective and efficient. In terms of health IT, it refers to optimizing the EMR and achieving meaningful use, as well as promoting a culture of improving patient outcomes and population health.
Health Information Exchange
Interoperability and participating in some form of health information exchange are big parts of optimization and key components of achieving stage two of meaningful use, as laid out by the ONC.
Being able to share data from the patient's chart or lab results with another clinic or hospital and having those be integrated into the patient's electronic records improves productivity and accuracy while giving the patient a more seamless experience between care settings.
Many tools are becoming available to support better health information exchanges and interoperability. Dignity Health's California Hospital Medical Center in Los Angeles offers one such tool, MobileMD. This is a web-based system that allows physicians to access patients' lab results, imaging results, and other transcribed reports. The data is filed in the patient's electronic chart.
Health information exchange is a key aspect of improving population health. Allowing providers to share patient information gives them a bigger picture of regional health and improves communication for developing strategies to address population health. Electronic medical records offer many benefits in providing care to patients, but as technology continues to develop, they will continue to evolve. That means having an adaptable plan for continued optimization and training will help you stay on top of the changes.
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