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The Five ‘Ps’ To EMR Implementation

Follow the 5 Ps: Purpose, People, Planning, Purchase, and Plunge

A physician friend of mine has decided to move forward with the implementation of EMR in his practice but has the same question that many physicians do: “where do I even get started?” There are many resources available out there, especially the internet, regarding EMR software, training, and related topics. The problem is, I told my friend, that all of these resources assume that you have a plan for your EMR project – where you are now and where you need to get to.

(click HERE to order the 5 Ps of EMR Implementation CD, Transcript and interactive mind-map)

What you need, I told him, is a basic overview of the entire EMR implementation process (in Getting Things Done parlance, the 30,000-foot level) before you start buying things and hiring people (experts and the like). Physicians are good at making quick assessments and decisions. That’s good for medical problems but not so good for things like major purchases (you’ve all heard the cliché about how physicians make bad business decisions). They don’t like to put off gratification when it comes to new gadgets and EMR is no different.

But doing your homework on a project of this magnitude is just what the doctor needs to order. That’s how I came up with the “5 Ps of EMR Implementation”: Purpose, People, Planning, Purchase, and Plunge. So, let’s cover each, one by one, shall we?

1. Purpose

What are your goals for EMR? Why do you want EMR? For the financial incentives? To make your practice more efficient? Are you running out of space for your paper records?

What is your vision of an ideal EMR system? A completely wireless system with portable tablet computers? Or desktop systems in every exam room with high-resolution monitors?

What specific features will the EMR system need to have? As the doctor, you may not know all the right questions to ask when it comes to such things as integration with the practice management system, coding and billing, technical specifications, etc.

Well-defined goals can avoid:

  • Unrealistic expectations
  • Inadequate customization of system
  • Loss of productivity
  • Ultimate abandonment of system

2. People

This is the most overlooked aspect of most major technology implementations – and one of the most common causes of project failure. Any time a new technology is introduced this can have a significant effect on people – this is what is known as change management.
In general, older staff members may be more resistant to new technologies and may require a longer learning curve. Younger staff members are more tech-savvy. Nevertheless, proper skills assessment and training is critical for everybody.

Who are the key players in your EMR implementation project?

  • Physician champion – there should be a strong advocate of EMR, preferably a physician, to keep the project on track and provide leadership, and deal with any issues concerning other physicians (training, liaison with EMR committee – see below – and handling resistant behavior)
  • IT Staff or Consultant – don’t rely on someone with limited computer skills, or your partner’s nephew, to handle the technical aspects of your EMR project. If your practice doesn’t have the resources to hire a full-time IT person, consider sharing someone with another practice or retaining an outside consultant, preferably someone with experience in EMR or computer technology implementations
  • EMR Committee – this is a group of people representing the different departments in your practice that will be involved with both the implementation of the EMR system and its day-to-day use

3. Planning

Have your key people involved from the beginning, before you buy anything

Set a realistic deadline to go live and use dynamic planning tools such as a Work Breakdown Structure (WBS) to keep your project on track – hire or consult with a project manager to help you with this []

Use mind-mapping software to ‘map’ out all the aspects of your EMR project – you can purchase robust software such as MindManager or use a more basic free one online

During your planning stages, break down your current work flow (how a patient ‘flows’ through a visit, from check-in to check-out) and your work flow processes (each step involved in an actual patient exam). How can they be more efficient? How can an EMR system streamline your processes? Knowing this now can actually help you decide which EMR system is a good “fit” for your practice.

Plan out a training schedule – getting your staff trained on both basic computer skills and your new EMR system will take time. Don’t let it disrupt your practice. Allow time either during the day when the clinic is light or after hours. And don’t forget to test those skills prior to your go live day.

4. Purchase – notice that this is only coming up at #4?


  • Network hardware
  • Network software
  • EMR software


  • EMR software last
  • Get your network up to speed


  • Wiring
  • Peripherals
  • Wireless devices

Involve your experts

  • Spend wisely
  • Don’t skimp on equipment
  • Beware of consumer level devices

5. Plunge

  • Set a hard deadline or it will never happen
  • Simulation of some kind – everyone involved
  • Feedback analysis
  • Keep lines of communication open
  • Bugs will be discovered
  • Champions need to keep everyone on track

Note: If you would like to jumpstart your EMR project, get our complimentary audio CD on The 5 Ps of EMR Implementation along with an interactive mind-map of the content – just click on EMR Implementation Plan.
Just cover the shipping and handling and we’ll send the CD (a $47 value), transcript and mind-map for free.

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