Kristin Pulliam
Senior Consultant
EMR Solution Set
 Allscripts Application Services
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Both Sides of the Story: One Consultant, Two Perspectives on Implementing an EHR
EHR Consultants: Is there a need? For many physician practices, the answer is absolutely. I have worked both on the client side and consulting side of an Electronic Health Record implementation. I first began my career in Healthcare IT as a Project Manager at a multi-location, multi-specialty medical school. My responsibilities included the successful delivery and implementation of multiple projects for departments within the medical school, including the rollout and implementation of Allscripts Enterprise EHR.
Since joining Global Works in 2006, I have assisted with EHR implementations at several multi-specialty organizations. I am able to leverage my experience as a client in an Allscripts implementation to guide my interactions with my clients and provide direction on the choices that they have to make. The client side experience has provided me with a better, more well-rounded perspective.
Not only does the implementation of an Electronic Health Record require the careful selection of a software vendor, but it also requires new clinical workflows to be mapped out. EHR Implementations involve a remap of the general clinic visit workflows. For example, a provider now signs notes, verifies results and authorizes medication renewals electronically. Prior to implementing an EHR, these processes were done on paper and were time consuming and highly manual. Remapping the workflows involves reviewing every process currently in place and identifying how this process will change with the use of an EHR. There are a lot of decisions that need to be made during the workflow redesign and understanding all of the available alternatives for the clients and the ramifications of those choices helps move the process along and improves the outcomes for the clients. As consultants that it is not our role to make choices for the physician practices, but rather to help them make their own informed decisions.
Once software is chosen and customized for the practice and clinical workflows have been designed and mapped out, it is essential for end-users to be officially trained on the software and new workflows. Training end-users is an area client-side experience makes a vast difference. As a Project Manager on the client-side, there are opportunities to visit and learn multiple roles in the organization including Front Desk, Medical Records, Billing, Nurses Station, Laboratory, Appointment Scheduling/Call Center, as well as shadowing the physician while seeing patients. When training the various roles of end-users, my experience working their individual jobs is useful. The experience of working the individual roles within in an organization allows me to see the small details that can have an important impact and can ensure a smooth transition to the EHR.
Many physician practices do not have the time or resources available for the daunting task of implementing an Electronic Health Record. Because the need to get physician practices on an EHR is so vital, it is a good idea for the practices to reach out to professionals and experts in the field of EHR implementation. For these types of implementations, it is imperative that the individuals implementing the EHR are knowledgeable of the software itself, as well as the implementation process.
Without this knowledge, expensive errors can be made. There are tangible savings to be found when working with professional consultants on the implementation team. For example, one client site did not want to make the investment in extensive training of their physicians on the EHR. Once go-live arrived, the physicians were at a loss and it slowed the clinic down tremendously. It is vital that clients take that extra time and make that extra step to ensure their clinicians and staff are properly prepared for the go-live of their EHR. This will make the transition to an EHR smoother for the clinic, and also for the patients.
Physicians are at times reluctant to move forward with an EHR and pay for outside consulting services. Ultimately, physician adoption is key to a successful EHR implementation. Consultants can provide valuable resources to physicians to assist in the adoption of the EHR but will also need to demonstrate the value of our services and to build trust with the physician practices. We can add a level of comfort to the implementation process, as well as keep this process on schedule.
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