Patient and Doctor

Implementation Strategies: Do I Need a Consultant?

Selecting and implementing an EHR can be a daunting process. Even a “tech savvy” clinician can be severely taxed by the sheer volume of work needed to make a decision regarding the choice of an EHR and coordinating the implementation and use of that system within the medical practice. A wide range of consultants is available to assist practices with this process, including independent and government funded Regional Extension Centers (RECs). Do you need assistance? And if so, how should you select a consultant?

Here are some guidelines to consider:

  • How “hands-on” do you plan to be with your implementation? You may be very comfortable with technology, and if you were involved with the selection of the EHR, you may fit the exact profile of a clinical champion. However, there is a difference between selection and implementation. Even though selection requires diligence in identifying the right product for your practice, implementation requires constant communication with colleagues and staff, excellent trouble shooting skills, and a significant amount of available time in order to do the job properly. If you are a solo physician or work in a small practice, you may be able to manage the additional workload associated with implementation; however, you will need to reduce your clinical workload quite significantly in the 2–4 weeks following go live and, with the added EHR project management responsibilities, your income will be further reduced during this phase.
  • If you are an eligible professional, you may qualify for assistance through a Regional Extension Center (REC). (Under Medicare, an Eligible Professional includes the following five types of professionals: doctor of medicine or osteopathy, a doctor of oral surgery or dental medicine, a doctor of podiatric medicine, a doctor of optometry, or a chiropractor.) Funding for Regional Extension Centers has been designated to support 100,000 eligible primary care providers to accelerate efforts to become meaningful users of Electronic Health Records (EHRs). If you qualify for assistance through your state REC, they can provide assistance to your practice regarding EHR implementation. Some of the RECs provide this service at no cost to the practice (up to a certain limit) and others require a co-payment to supplement the costs of providing the services you require. For more information on the Regional Extension Centers and to find the Center near you, click here.
  • If you are in a larger group of 10+ physicians or a multidisciplinary group practice, the level of complexity with implementation increases exponentially as the practice becomes larger. In these circumstances, it is wise to consider getting outside, third-party assistance. If you have led the selection of your EHR, you are well positioned to be a super-user (someone who has received additional training to use the EHR who can act as a leader or expert guide for others in the practice). This in itself can be quite demanding, particularly in the first few months following implementation, as your colleagues and staff encounter problems that they are unable to solve.
  • Be realistic. If you have a spouse and children, it is a good idea to have additional support/expertise with the implementation process if you do not want to be a stranger at home. A good project manager with experience in EHR implementation is going to be much more effective than a stressed-out physician who is trying to maintain a practice while coordinating an IT project.
  • If you are going to lead your EHR implementation and have partners or associates in your practice, reach an agreement within the practice regarding your compensation for the time that you will be taking from clinical care to manage the implementation. For example, 50% in the first two weeks, 30% in the following two weeks, and 20% for the second month after go live. In addition, budget time appropriately for the pre-implementation phase. (Note: Everyone will see a reduction in income during EHR implementation, so take this into account when budgeting the cost of your time contribution.)

With some forethought and planning, you should have a good strategy in place to ensure successful implementation of your EHR. Be willing to ask for help and ensure you check references when selecting a consultant to assist you. A local consultant who knows your practice and is available to assist at a future date when you begin EHR optimization is a valuable resource.


4 responses to "Implementation Strategies: Do I Need a Consultant?"
  • September 29, 2011
    Mark Norris

    Technically Incorrect – While you are correct on Medicares definition of an EP, a different definition is used by REC’s. It covers only Family Practioners, Internal Medicine, OB/GYN’s and Pediatricians – all others in Medicares definition are not eligible for subsidized or “free” REC services. In my region, we serve those other specialities listed, but on a fee for service basis.
    Hope this helps. Keep in touch. Mark Norris, Executive Director , NEO HealthConnect

  • September 29, 2011
    Evan Leibowitz

    Hi Mark, I’m in a multispecialty practice in Northern NJ. We have mostly Internal Medicine, Geriatrics and Family medicine. However we also have 3 Rheumatologists. Would we still be eligible for free REC services or would we have to pay because of the 3 rheums since technically they are not PCP’s. Thanks. Evan

  • October 4, 2011
    Rick Crespo

    Please call the local Regional Extension Center. We have services available for both primary care providers and specialists!
    -Rick @ NJ-HITEC

  • October 13, 2011
    Mark Norris

    Evan –

    I can only speak to how we manage it in Ohio, but yes you should get the benefit of services covering your entire group. Because your PPCPs qualify for services, and based on the assumption that you will all move forward as a group, the same process should apply. I agree with Rick, call him at NJHITEC for next steps. Good Luck!

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