1. Start a User’s Group.
This is not a Providers only club. This is a forum that meets in person, hosts a Web-X for those that cannot be there, and has super users show “Tips and Tricks” as well as vendor sponsored events. Anyone with log-in credentials to the EMR is invited. This is an opportunity to talk about what is working. This is not a change management committee or a vendor bashing session. Keep it focused on productivity and information exchange.
2. EMR Committee.
Did you really think that you were done with the EMR committee when you went live? You need a forum that is empowered to receive enhancement requests, template revisions, 3rd party applications review and recommend changes in policies and procedures. The EMR Project Steering Committee goes away, but this group is the traffic cop designed to funnel all the great ideas (and not so great) that users come up with. If you really want to empower this team, assign a percentage of your I.S. application customization budget to them. That’s right, give them budget responsibility and let them prioritize what custom templates or features/functions get changed for a given fiscal year.
3. Are you “Live” or on “Life Support?”
I define a full featured EMR as: “Note Templates, CPOE, integrated into your billing system, interfaced with your clinical data, and communicating with your RX clearinghouse.” If you don’t have these basic requirements then you celebrated too soon. You can ease someone into using the EMR by providing basic functionality first, then adding the rest later. But you have to be prepared to keep the resources engaged for your next phase(s).
If you are using Dragon to populate the Note, you need to build some processes to check all the right boxes to report your MU numerator and denominator. The number one complaint is: “Why did I spend all those years in Medical School to become a typist.” The truth is somewhere in the middle. Dragon has its place in the EMR world. But you need to get away from thinking that some dictation company will clean it up and make it ready for posting in the medical record. You are dictating directly into the note now. The provider not only owns the entire process, but they also have to review the medication list, problem list, allergy list, CPOE Meds, etc. Dragon will only get you so far, the rest of the way is point, click and type.
