Make IT vendors your partner for a smooth EMR transition

Vendors talk about partnering with medical practices all the time – especially in the information technology (IT) world of electronic health records (EHRs) and practice management systems. But, ask any physician about their IT solution and most will express dissatisfaction, unhappiness, or harsh complaints.

The reason? For the most part, medical groups are not trained effectively for integrating IT into their work flow.

Ask EHR vendors about their approach to training and most express frustration with their clients’ lack of attentiveness — or actual lack of attendance — at training sessions. Vendors complain that physicians just won’t make the time to be trained.

Who’s right? They both are! The fault for ineffective training lies with both parties because they have not learned or understood what it means to partner.

Training is critical before going live on an EHR, and ongoing training is essential for optimizing the EHR implementation after go-live. First-time buyers don’t know what they don’t know and have been lulled into complacency by the simplification of so many consumer technologies. The EHR is a much more complicated tool than the self-service kiosk at which you buy movie tickets or the fitness app you download from iTunes.

That EHR complexity requires training in earnest and all too often the unknowing buyer eliminates many hours of training during initial negotiations with the vendor. The vendor is willing to go along with it because they want to make the sale of their software, and training dollars are just a resource cost that passed through to the client – no real profit in those training revenues.

But true partnering means that the vendor guides the physician to understand the importance of their training investment, and the physician understands that the vendor is as interested in his success as in their own. Both parties must understand that aggressive negotiations often leave one party ill-prepared for the future.

Why working as partners is key

Effective use of technology can control and reduce operating costs in a medical practice. Technology can drive revenue, monitor reimbursement, and position and support a practice’s participation in payers’ new reimbursement models. But only if the practice is well trained in the utilization of that technology.

The EHR vendor is expert at training on the features and functionality of their technology. The vendor is not expert at how best to incorporate those features and functions into various practice work flows.

The physicians, nurses, reception staff, medical secretaries and ancillary support staff in a medical practice know their needs and work flows. The vendor knows how their EHR works.

The integration of those two fields of expertise is where the appropriate training plan can be delivered.

Just knowing what to click on to write a prescription doesn’t help the physician-nurse team that is coordinating incoming patient phone call requests for prescription renewals. Examining the current process, understanding the potential process the EHR makes feasible, and then training the physician-nurse team on the technical aspects while re-engineering the daily processes is the recipe for success.

A good physician partner puts the best staff on the project with instructions to collaborate and cooperate with the vendor. As good vendor partner listens to the practice representative and commits resources that truly customize the standard curricula to fit the practice’s day-to-day operational needs.

A partnering solution requires compromise and cooperation.

The vendor must be willing to modify their scripted, plain-vanilla training curriculum, and the practice must be willing to devote time to self-evaluation of work flow and time to be trained.

Too often the vendor has a time line and pushes aggressively to stick to that time line because they have committed their training and implementation staff to other engagements. Equally often the practice continues to juggle patient appointments during training sessions and shortchanges themselves out of the learning opportunities that will optimize their implementation.

Partners commit the resources to the project. That means reduced patient-care hours, or overtime for the practice. For the vendor, it means they might be training in the evening or on the weekends.

What good partnering can bring

Physicians and practice managers have told me that they’ve missed meeting e-prescribing requirements and will therefore face future penalties in Medicare reimbursement. Many practices are struggling with qualifying for the HITECH meaningful use incentives.

In each of these practices, their technology implementation is the reason they are fighting reduced reimbursement.

Better performing practices have figured out how to increase profitability with the effective use of technology. Those groups that spend more on IT (including training) per FTE physician, tend to generate more medical revenue after operating cost per FTE physician.

Declining and/or changing reimbursement and rising operating costs are three of the top four challenges sited in the Medical Group Management Association’s annual survey as reported in “Medical Practice Today: What members have to say” in the July issue of MGMA Connexion magazine. In fact, every year in the last four years of the survey, those same challenges have been in the top four.

Those are only the results of ineffective technology utilization – technology is the number one issue for providers and staff.

Rosemarie Nelson is a principal with the MGMA Health Care Consulting Group.

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