Top 10 EMR Installation Mistakes

by Jason Davies on August 30, 2011

Here are what I consider the top 10 EMR installation mistakes.  TechRx, Inc. provides consulting services for physicians, clinics, and hospitals who need to make the right decision regarding EMR.  Let me show you how my brilliant mind can ensure you make the right choice.


1. Not fully understanding what third (3rd) party means.

  • Once the contract is signed, you may quickly find out the majority the provider offering will be provided by a 3rd party. Software vendors love to get you to buy into an expensive software package, only to have you find out that many of the functions will be done by 3rd party software. An example could be your billing products. Then, you find out if you have a problem, your software provider wants you to work directly with the 3rd party vendor. This creates a nested mess, you are tied to the software, and it lacks support.
  • Your electronic billing provider and prescription clearinghouses. Your software provider now has you, what happens if a particular vendor has a bad network day. Are you prepared for the inevitable workflow problems you may run into?

2. Starting your accounts at zero, and interfacing.

  • As you know clients pay slow, and you may have billing accounts that age.  Many vendors will simply say, start a new month at zero and work with that. Their support says nothing about converting, or moving data into your new software.
  • Does the software implement with your existing lab system, or does the vendor say they require a specific interface engine? EMR is a big index into the voluminous amount of data. Can you easily connect; or will it require much more money, and many hours of custom work; further maintenance etc.

3. Too much or too little, physicians are impatient.

  • Every clinic will have one doctor who is eager to jump on the latest technology. They will be impatient and want things their way. This is because, they will embrace technology before the other practitioners. The result, first come first serve. If this is done the wrong way, the project may drag out as requirements become more specific.

4. Is your administration on board?

  • At the end of the day, the clinic administrator will make the decisions about your software. They will be responsible for compliancy and they will need to be trained. The resources in training are significant, you need to make sure you have a great choice. If you think your administrator may jump ship due to new requirements, be prepared. Changes in leadership during large project implementations can set off a waive of problems. Will your technology provider and administrator collide on ideas? Establish rules for your technology providers, and administrators if transition is a must. Avoid at all cost.

5. Requirements for functionality need to exist.

  • Your usage of EMR will dictate your ability to meet meaningful use, and Physician Quality Reporting.
  • Again, see #3. Many physicians will try to resist EMR. Once they embrace it, you are all set. However, make sure everyone is on board BEFORE implementation. This way, you can make a checklist, check it a minimum of 10 times, and meet your requirements. Especially useful during an audit.

6. Work with your vendor on a useful timeline.

  • Software vendors use many crafty words to determine when a project is live, and that is why they require money once a software is life. What determines live? Delivery of computers into your storage room, and a DVD is not considered live. However, I came across words similar to that in a contract once. “Delivery of solution is considered live.” The vendor demanded payment upon arrival. This vendor never made a deal with the client.
  • Other vendors will implement a first round of users to go live. Perhaps, your transcription department and reception. What about the lab systems, treatment systems, and physicians? Make a real timeline, and ask your vendor if they can meet your goals. EMR is a two way street. With 2014 jus around the corner, there are vendors just waiting for a slip up.

7. People factors

  • When you decided to implement a particular solution, the practice physicians saw an impressive array of technology at a trade show or other presentation. Your nurses, office staff, and reception did not. People are frustrated by change because things will never be the same. Often, this creates fear, panic and chaos. Those are three words you do not need to hear when you are converting to an EMR solutions.
  • Hold meetings with your entire staff and prepare them for what is coming down the pipe. The more people know the better they can be prepared. If certain people seem resistant to change, the additional time may be the catalyst to their improvement, or downfall. Whatever the direction, everyone needs to be informed, and above all: People are humans. To expect is one thing, but when it pushes good working people past their comfort zone it is time to review the strategy.

8. Failure to plan is planning to fail.

  • The chicken crossed the road to get to the other side. Simply put, point A to point B. This creates a simple outline of what was expected and what the outcome was. With EMR, the failure can be in over planning. When thinking EMR, you need to think long term, short term, and now. Find out how to get from point A to point B without total chaos. Setup a reasonable amount of goals, and guidelines for your vendors. Make it happen.
  • If you spend too much time working on the details, your project will come crashing down. As much as you feel it is important to have a map of your entire network, documented IP addresses, and knowledge of every piece of memory in a server; let me reiterate, this is NOT important YET. Eventually, once the project is done, you need to have a map. However, your focus is implementing medical records and making them useful before the deadlines hit.

9. The infrastructure is yours.

  • Many clinics have Citrix in place and it works great. Do not expect Citrix to play well with others. Remember, most software contains third party pieces. They have their own unique requirements, and bandwidth usage. In fact, they may have proprietary printer drivers that Citrix hates. Ask the Citrix question right away.
  • Also depending on the contract that you sign, check with your provider to see who takes care of infrastructure and software issues. If there are technology issues between Citrix and a workstation, who do you have to call first?

10. There is a difference between EMR and data storage.

  • Some clinics think EMR is simply scanning a bunch of images into their program. Scanned documents that produce a static page are not EMR. They are simply stored data.
  • The upgrade to EMR is to provide a flexiable experience. Computerized Physician Order Entry decreases delay. That is why you need to provide your users with data that you can modify, formulate, and work with. Remember, if you make the patient a priority, you build a relationship that will be long lasting. Better response time means better treatment. That can be a selling point.







{ 1 comment… read it below or add one }

EMR Software August 31, 2011 at 5:09 am

Oh! what a great post… EMR can deliver unmatched benefits if and only if implemented properly. It is therefore very important to control the possible mistakes during the process of implementation.

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