Task specification, phased approach can help small practices adopt EHRs

Small practices that are just now preparing to adopt an electronic health record system may be slightly behind the curve when it comes to industry-wide rates of implementation, but meaningful use incentives are still out there for the taking. According to guidelines published by the Centers for Medicare and Medicaid Services, practices that seek to qualify for those reimbursement payments must begin a 90-day period of EHR use by no later than July 1, 2014, and be ready to attest by Oct. 1 of the same year.

Large health care organizations may have enough revenue to throw at the problem of EHR implementation and hope it goes away, but small practices must be smarter about how they delegate their resources. Fortunately, a rural hospital in Alabama successfully implemented a full EHR system into its workflow and is ready to attest for meaningful use stage 2 in the fall, EHRIntelligence reported. Any practice that is in the process of adopting EHR software should take notice of the steps this small hospital took to minimize disruptions and maximize efficiency during the implementation program.

Compartmentalizing work
Located in Brewton, Ala., D.W. McMillan Memorial Hospital is a community-based health care provider with only 48 beds throughout its entire facility. Lacking the resources of a larger conglomerate, administrators took pains at the very beginning of the EHR implementation process to ensure that their staff members were not overloaded with work.

EHRIntelligence explained that segmenting the EHR software into its constituent parts and delegating staff members to learn only those sections helped the hospital quickly adopt the technology. The quality assurance manager at D.W. McMillan was responsible for the user experience when it came to bar-coded medication, while a nurse manager was tasked with creating predefined order groups. 

This system allowed each staff member to intimately learn a small section of the EHR system. By sharing work among the entire facility, the system was incorporated into normal practice much faster than if a single employee or department was forced to oversee the implementation into all areas.

Approaching adoption in phases
Much like separating work among employees, introducing EHR technology to the workplace in predefined stages helped D.W. McMillan gradually ramp up its expertise and reliance on the software. HealthIT.gov recommended tailoring EHR adoption to each individual practice's needs and resources, and a small staff may not have the manpower necessary to handle a full EHR system all at once.

First to transition to an EHR-based approach were the medical, surgical, intensive care and obstetrics departments. When that transition was completed, others followed. Not only does this minimize the disruption that learning a new technology will cause to certain sections of the workplace, but the lessons learned in early stages of adoption can be used to make the later phases move more smoothly. When choosing which departments to prioritize, small practices with an eye toward meaningful use incentives may want to select those areas that the CMS looks to during the attestation process.