Implementing an EMR system has moved from a “nice to have” to a “must have”. Choosing the right system for your practice can be overwhelming, confusing and tedious. What’s worse? Having spent precious time, energy and financial investments, only to realize the EMR system has made things worse, and none of the benefits promised have been realized. In my opinion, the primary reason that implementation of a good quality EMR system may fail is because it is never adopted by the clinical staff. If your clinical staff (therapists and assistants) do not embrace use of the system and use it as intended, the system will not live up to its promise. In worst cases, the entire implementation may become a complete failure.
I have seen businesses search for a “better system” after a failed implementation when, in all likelihood; the failed implementation may have had little to do with the EMR software.
Let’s explore why PT clinics adopt integrated EMR systems, and how to prevent a failed implementation.
Why Implement a System at All?
Traditionally, PT clinics have had a mix of some manual paper systems and computer based, non-integrated “point solutions” that only address portions of the business workflow (scheduling, documentation, or billing).
More recently, some PT clinics have been switching to totally integrated EMR systems for a variety of compelling reasons. Here are some of the most common:
- Compliance with Medicare and other regulatory agencies.
- Payer Requirements: Special billing rules and specific payer requirements for clinical reporting.
- Enterprise Efficiency: Document management, charge aggregation, automated auditing of the clinical record, automated claim validation, and electronic claim submission and remittance.
- Claim Accuracy: Charges on claims match the clinical documentation record.
- Revenue Capture: System supports insurance verification, authorization tracking, billing capture, and patient collections.
- Physician Communication: Standardized report layout and formatting.
- Clinical and Financial Outcomes Tracking: The ability to marry clinical outcomes with cost data is becoming increasingly important.
- Clinical Content Management: Ability to have a configurable standard library of content that may be utilized as part of the clinical documentation.
Therapist Adoption
Remember, in my opinion there is only one major reason that some EMR implementations fail: therapist adoption of the system. In the worst case, the clinical staff explicitly rebels against using the system. More commonly, the staff simply refuses to adapt to the system and use it as designed. If the therapist refuses to use the system as it was configured and as designed, it just won’t live up to the potential that was envisioned in the sales process.
Here are the common reasons that EMR systems aren’t successfully adopted by the therapists:
Clinical Leadership
The most important reason for failed implementations, in my view, is lack of clinical leadership. The clinical leaders in the organization have a responsibility to make sure that the clinical staff understands that accurate, compliant documentation that establishes medical necessity is a primary responsibility not extra work.
EMR Systems are capable of assisting the staff in providing compliant documentation that supports medical necessity, but they cannot work magic. The therapist using the system has to be engaged in the process.
Training
You need to dedicate time to training. Adoption of an EMR system can be a huge change in your normal clinic workflow. It is unrealistic to believe that anyone will be able to adapt to a new system and efficiently utilize all of the features of the system without adequate training. In our experience, only about 20% of therapists will complete training on their own time.
Setting Expectations
It is not always realistic to believe that adopting the EMR will allow clinical staff to spend less time documenting. Nothing is faster than poorly done hand written documentation.
System Features
To be sure, there are some system features that make therapist adoption easier. The system needs to be responsive and must be flexible enough so that the clinicians can accurately communicate their findings without extra work.
How to Succeed
Clinics who successfully implement EMR systems:
- Configure the system to provide guidance and minimal requirements to assure compliance, not edicts on all of the content in clinical documentation.
- Don’t make large changes in the clinical content library during implementation. You will have a much better grasp on what you want to change after actually using the system.
- Recognize that configuring the system never really ends. Truly successful implementations of any software system continually refine the system to meet changing needs.
Consider Clinicient
