With just over 100 responses to our EMR survey (and counting), I decided to go ahead and post the results thus far. Reader responses are listed in decreasing order, from most votes to least.
Question #1 – Our practice is currently using:
- EMR on a limited basis – 30%
- EMR to a significant degree – 26%
- ePrescribing only – 25%
- No EMR, just practice management – 17%
Question #2 – My role in the practice is:
- Administration – 32%
- IT (information technology) – 28%
- Clinical/Medical Tech – 22%
- Physician/Partner – 18%
Question #3 – We anticipate the costs of EMR to our practice will be:
- More than $10K per provider – 46%
- Not sure, we have not made the transition yet – 24%
- Between $5K and $10K per provider – 20%
- Less than $5K per provider – 8%
Question #4 – Our biggest obstacle to EMR implementation is/was:
- Physician resistance – 32%
- Lack of useful information/not knowing where to start – 26%
- Uncertainty about which system to get – 26%
- Cost – 15%
Question #5 – Our practice size/situation is:
- Solo practitioner – 50%
- Small group, 2-5 physicians – 31%
- Mid-size group, 6-12 physicians – 12%
- Large group, less than 40 physicians – 3%
- Mega-group or clinic, more than 40 physicians – 3%
The most interesting answers I think were to questions 3 and 4. A majority of respondents feel that the cost of EMR implementation will be at least $10K per provider and that physician resistance is the most common obstacle. I am actually not surprised about that last one as that was a major issue in our practice.
Questions or comments? Post them here….
I’m not surprised about the top response to item #4 either. After all changing from a paper to an electronic system really alters almost every aspect of a clinician’s workday. And let’s face it … change can be scary! Also, with a practice’s need to maintain proper levels of productivity from it’s clinicians, making such a monumental change often means that productivity takes a hit … at least temporarily. That’s where good planning and preparation come in, enabling a practice to better make a smooth transition and more quickly begin to reap the benefits of an EMR. I listened to your podcast about your “simulation weekend” prior to going live with your system. I thought that was an excellent exercise.
So what were the deciding factors that prompted your group to get past that barrier and move forward?
Thomas, thanks for the comment. Fortunately, we had enough of a consensus and a little momentum going into the project. We were running out of physical office space for paper records. But I think it was the potential for financial incentives for EMR use that provided the tipping point. The other thing that helped was getting the nay-sayers’ templates up and running before the rest of us. This made the transition for the less tech-savvy doctors less traumatic and brought them back from the ‘dark side’ that much sooner.
Hello Dr. Polack,
Your solution mentioned in the above response for making the EMR transition less traumatic for less tech-savvy/ “Resistant Physicians” was very insightful.
How did you handle the early education and final training for go-live with those nay-sayers?
Was it done individually? In groups?
How do those early resisters feel about the system today?
Do you know anyone else who has handled resistant doctors this same way? What results did they Have?
Thank you,
Nina
Nina, thanks for your comment. When I talk about nay-sayers, I am generally referring to physicians (I would think that employees who are not on board would be dealt with accordingly). If they are demonstrating significant resistance, they should be dealt with peer-to-peer. I would not put an administrator or other staff member in that no-win position. Initially, their training should also be given by a colleague if at all possible. After ‘basic training’ one of the well-trained employees or ‘super-users’ can take over from there. I think in both cases it is best to do this on an individual basis since much of the resistance is due to feelings of self-consciousness about not being facile with computers and they wouldn’t want to be potentially embarrassed in a group setting. Also, since the system we used allows full customization of templates for each individual doctor, we got these doctors up-to-speed with their own templates before the rest of us had ours.
In the end, I think this approach worked well for us. Everyone is getting used to seeing patients on EMR and we are no longer hearing complaints about our decision to go paperless. And since we have just completed a little over a year on EMR, we are already starting to see patients in follow-up on EMR – an exam that used to take several minutes to document on paper now takes about 2 minutes and 2 clicks of the mouse. So even our skeptics are smiling about that.
Thanks for giving us the details. Sounds like your sensitive and supportive colleague-training gave you reluctant associates the comfort and the necessary space and time to master the tools of the future. Nice strategy. Great lesson.