My Practice Wants To Adopt An EHR


  • MSOs Are Here to Help
  • CRISP Consultation
  • Readiness Assessment
  • EHR Selection Toolkit

CRISP's Regional Extension Center Program is a resource to help Maryland primary care providers with a suite of direct technical assistance services that can help with EHR adoption.  Simply buying an EHR and expecting quick results is an unrealistic expectation.  The process of EHR adoption is complicated and can be risky if not executed properly.  This is where CRISP can help you.  We invite you contact CRISP at rec@crisphealth.org, or contact one of our MSO partners directly for assistance.  Visit our MSO Directory to find an MSO that can help you.

Direct Technical Assistance Services Provided By MSOs at No Charge

  • Training and Education – Learn about the effective strategies and practices to select, implement, and meaningfully use certified EHR technology. Provide or facilitate EHR application training with EHR vendors or partners.  Provide materials and hold training events and programs for the practice.
     
  • Practice and Workflow Redesign – Provide support for practice and workflow redesign necessary to achieve Stage 1of meaningful use.  Work with EHR vendor(s) to optimize the use of the EHR systems for the consistent documentation of essential clinical information in structured formats by instituting electronic administrative transactions, electronic prescribing, electronic laboratory ordering and resulting, sharing key clinical data across practice settings, providing future patient access to their health information, public health reporting, and policies and practices that protect the privacy and security of personal health information.
     
  • Project Planning – Provide project management support for the EHR implementation process, including individualized coaching, consultation, troubleshooting, and other activities required to assure that the provider is able to assess and enhance organizational readiness for health information technology (IT), assess and remediate gaps in IT infrastructure, configure the software to meet practice needs and enable meaningful use, ensure adequate software training for all staff, and track and adhere to implementation timelines.
     
  • Progress Toward Connecting to CRISP Health Information Exchange (HIE) – Assist providers with connecting to the statewide HIE infrastructure (note: while there are no CRISP fees for providers to connect, certain EHR vendors may charge for interfaces to be built). 
  • Privacy and Security Best Practices – Support providers in implementing best practices with respect to the privacy and security of health information, including: implementation and maintenance of physical and network security, access controls, disaster recovery, encryption and storage of backup media, human resources training and policies; and identification of state laws and regulatory requirements that impact privacy and security policies for electronic interoperable health information exchange.
     
  • Progress Towards Meaningful Use – Assist Practices by reviewing the utilization of the EHRs, and providing appropriate feedback and support to improve low utilization of features essential for meaningful use (e.g., electronic prescribing).  Help providers to understand and implement technology and process changes needed to attain meaningful use requirements.  Assist providers with understanding CMS reporting requirements and work with provider’s EHR vendor(s) to gather the specific data in order to report.

Ready to move forward with selecting an MSO and an electronic health record product?

CRISP can offer a free, unbiased consultation to your practice to help get the process started. It's your choice -- we can provide this consultation via email, phone or even in-person in your practice. We also offer a self-assessment that will allow you to diagnose your practice's needs on your own.

Contact CRISP today at rec@crisphealth.org or (877) 95-CRISP.

Evaluate Your Readiness to Implement an EHR

AmericanEHR Partners has developed a Readiness Assessment to assist you in evaluating your preparedness for EHR implementation. The format is simple. A readiness score will be generated by answering a set of simple questions relating to preparedness in key areas that affect EHR adoption.

Take the Readiness Assessment Test

[Disclaimer: This Readiness Assessment Tool is provided as a guide that can be used in the preparation process for implementing an EHR and does not address all areas or situations. Users are advised to make decisions about EHR selection and implementation only after a thorough assessment of individual and practice requirements.  This tool has been developed and is being maintained by American EHR, a third party; CRISP has not been involved in its development.]

Selecting an EHR

The EHR you choose will transform not just the business side of your practice, but also how you care for patients. Your EHR is more than just an expense: it’s an investment in the future of your practice.  This is why CRISP has invested so much time in assembling the right team of MSOs to help you with the transformation. 
 
Because you’ll use the EHR for nearly every aspect of your work for many years, choosing a system that most closely matches your needs and work style is crucial. The more you understand about how you work and what you want, the more likely you are to select the right EHR.
 
Making the right choice means making an informed choice. Don’t limit your options only to the systems you’re familiar with. 
 
Understand your goals and do your research. When you master the variables, you control your process, costs, and results
 
Before getting too deep into research or selection, we strongly recommend engaging one of CRISP's MSOs to prepare yourself and your practice for the change. Doing this work now will save you time and aggravation — and even unnecessary cost — later.  Our MSOs can help you:
  • Complete a work flow analysis
  • Select a physician champion
  • Start to create buy-in at all levels of your practice
Determine Your Strategy
 
Honestly assessing your practice and workflow can reveal opportunities for improvement. We recommend a workflow analysis as a key step in preparing your practice for an EHR. Once you have an understanding of the inefficiencies in your current workflow you can begin to formalize your strategic plan.
 
CRISP's MSOs can help you develop a strategic plan by thinking about what you want to see accomplished once the EHR is up and running in your office. This will help move the project forward over time. Your strategy could aim to:
  • Increase communications efficiency through instant access to patient records
  • Reduce duplicate tests or labs
  • Improve coding accuracy
  • Reduce transcription costs
  • Improve legibility of notes
  • Quickly print off patient education content
  • Access patient records from off-site

Learn the Basics

Confirm EHR Cerfitication

The EHR you choose must be certified to meet meaningful use requirements by an Authorized Testing and Certification Body (ATCB).  These entities have been authorized by the Office of the National Coordinator (ONC) to perform complete EHR and/or EHR Module testing and certification. 

Certification by an ATCB will signify to providers that an EHR technology has the capabilities necessary to support their efforts to meet the goals and objectives of meaningful use.  To see a complete list of EHRs and EHR Modules that are certified by ATCBs, click here.

Where is the Software Hosted?

 There are two options for EHR systems: ASP and Client/Server .  CRISP's MSOs can offer you both.

An Application Service Provider (ASP) hosts software on a remote system and offers access as a subscription. That subscription – usually a monthly fee – provides you hardware and software. Because the system is offered on subscription, the ongoing costs are consistent and there are no high upfront expenses.

With an ASP, you do not host your system. Instead, the ASP supplies the EHR and its data from a secure hosting facility (which includes disaster recovery and backup). Ensure that any ASP agreement specifies who owns the data and how it can be accessed or moved. 

CRISP's State Designated MSOs are required to have their data center accredited by EHNAC, a a federally-recognized, standards development organization.  To read the EHNAC MSO requirements, click here (pdf). 

ASPs protect data using firewalls and HIPAA-compliant encryption and maintain uptime using redundant systems. To use an ASP, you’ll need a high-speed internet connection in your office, as well as a computer network and other software.

The Client/Server model is a system installed in and managed by your office. Client/Server installations give you more control over your data and server. They require a number of components, based on practice size, including: 

  • File servers
  • Workstations/tablets/laptop PCs
  • Personal digital assistants (PDAs)
  • Printers
  • Fax machines
  • Networking hardware (hubs, switches, routers, cabling, etc.)

This choice carries high upfront costs and requires ongoing support from IT contractors or in-house staff, but also offers depreciation savings.

Equipment Options

When considering your hardware options, most MSOs can help you answer important questions about the best position of the equipment in exam rooms like:

  • Where will patients sit?
  • Do patients want to see the screen during their appointment?
  • Do you prefer typing, using a tablet PC, or both?

The answers to these questions will help determine what hardware best meets your needs.

  • Laptops
    • Offer portability between rooms and locations
    • Reduce costs — each provider needs just one PC
    • Integrate keyboard and mouse
    • May require backup batteries; most laptop batteries last 2-6 hours
       
  • Tablet PCs
    • Offer multiple configurations: laptop-style or pen-based
    • May require backup batteries; most laptop batteries last 2-6 hours
       
  • Desktops
    • Are tied to one room
    • Should be in exam rooms, common areas, and offices 
    • May provide faster network speeds
    • Require patient-provider interaction considerations

Narrow Down the Vendors

With so many EHRs making competing claims, it’s hard to know where to start narrowing down the market to a few systems that meet your needs. Plus, you have patients to treat — you can’t spend all your time researching. 

 
CRISP and their team of MSOs can help make things easier for you by making vendor selection a two-part process:
  • First, we help you eliminate unsuitable options and familiarize you with EHRs in action at colleagues’ practices.
  • Second, we offer tips on getting the most out of vendor demos when you are evaluating your top contenders. 
 
Ensure Compatibility with your PMS
 
Your PMS and EHR must communicate. To avoid wasted data entry, your Practice Management System and EHR must be able to share data.
 
Don’t let EHR vendors make you their first compatibility test. Ensure that their system has demonstrated compatibility with your PMS
 
Considering changing your PMS? If you expect to make a change any time soon, it makes sense to choose a new one before you buy the EHR to ensure compatibility.
 
An EHR is not simply an add-on to a PMS. Don’t treat it that way.
 
Review Systems for Your Practice Size
 
Be clear about system capacity and your practice size. Don’t consider — let alone purchase — an EHR suited to a practice larger or smaller than yours. Be clear in all your vendor communication about the size of your practice and what you are seeking from the EHR. It will save you from considering products unsuited to your needs. 
 
Perform Due Diligence
 
Learning from your colleagues. Some of the most valuable resources in this process are colleagues already using EHRs. Ask them for their advice and recommendations in person, via email, or on our Messageboard. Medical society websites, conferences, and vendor events are also great places to garner valuable information.
 
Try before you buy. You wouldn’t make any big investment sight unseen, whether it’s a car, a house, or an EHR. Get a sense of how the product you’re considering works by shadowing a colleague who’s already using it or a similar system.
 
Of course no two practices are identical, and the product you’re considering may not be easily available locally, but any observation-based learning you can do will serve you well. Physicians who say they’re too busy to do this research often end up regretting it. 
 
Shadowing a colleague gives you a deeper understanding of how an EHR will work in, and change the flow of, your practice
 
Remember, you can take advantage of the physician community on this website to learn more about selecting and using EHRs in your practice. Colleagues who have successfully implemented systems are available in the Messageboard and Questions & Answers sections to share their experiences.
 
You can also find a doctor like yourself to learn from.
Prepare for Demos
 
Seeing the EHR you’re considering in action is an important opportunity to learn about the system and whether it will fit your needs. That’s why vendors offer demos of their products. These tips will help you get the most out of that demonstration.
 
To prepare for the demo, write down a few scenarios common in your practice and ask each vendor the same set of questions. Consider questions about:
  • Importing demographics and immunizations
  • Prescriptions customization
  • Documenting developmental information
  • Plotting BMI
  • Remote access
Focus on how the EHR helps you find patient information, manage health maintenance, review labs, and write prescriptions. An EHR is much more than a note-taking system.
 
Create a rating form and ask your colleagues to fill it out after each demo. The form should rate compatibility with your needs, workflow goals, and overall ease of use/flexibility.
 
While asking the vendor for a list of local physicians using their EHR is key, remember that list will probably be made of their supporters. Looking beyond that list is a requirement.
 
One place to look for that feedback is our Messageboard. There, you can get feedback about the system you’re considering from colleagues with similar practices.
 
Check references. Call at least three of the customer references given to you by vendors. Look for references that include one or more physicians, senior management, and an information technology staffer.
 
Prepare for these calls by making a list of questions like:
  • How are the templates? Were they pre-loaded? How are they edited?
  • What percentage of providers uses the EHR?
  • What functions are most used?
  • Do providers still dictate?
  • Have you saved money or broken even?
  • Does the EHR interface with your lab?
  • How many interfaces do have?
  • What PMS do you use?
  • How does remote access work?
  • How have patients reacted?
  • What don’t you like about your EHR?
  • Have you had downtime?

 

CHESAPEAKE REGIONAL INFORMATION SYSTEM FOR OUR PATIENTS
CRISP  ·  7160 Columbia Gateway Drive, Suite 230  ·   Columbia, Maryland 21046
T/877-95-CRISP (27477)  ·  F/443-817-9587  ·  info@crisphealth.org
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