Imagine: You are in the last phase of your electronic health record (EHR) implementation process. You have performed a practice-wide readiness assessment, determined your selection criteria and finalized a choice of EHR, implemented the technology throughout your practice, analyzed the federal government’s EHR incentive program, set the terms of your software licensing agreement, and chosen the appropriate hardware and privacy controls for your software. (These topics were covered in the first six articles of this series.) This last article in this seven-part series provides an overview of the technical support your practice will require as well as how you can integrate other technologies into your EHR to provide maximum benefit.

Apps

After you have successfully implemented your EHR throughout your practice, you will want to investigate different types of interfaces or applications for your software. Smartphones are becoming increasingly common amongst the U.S. population and physicians are no different. A recent survey by Manhattan Research titled “Taking the Pulse v9.0” found that 64 percent of physicians use smartphones (e.g. iPhones, Blackberrys, Treos, etc.). Several EHR companies have begun offering applications so physicians can begin using their software on iPhones, iPads, and other smartphones and tablets. In terms of hardware, some physicians prefer using a smaller device to pull up their patients’ medical chart as they can become increasingly mobile and perform a lot of tasks on-the-go.

Additionally, many physicians use various apps during the patient visit. For example, some physicians look up dosages of common medications through an Epocrates app. This information is available instantly through a smartphone and can be added to the patient’s medical record in seconds.

Another common app involves transcription. Many dermatologists are interested in seamlessly integrating transcription into their EHR so they can limit the amount of time they have to spend typing. Several companies offer apps or interfaces with EHRs to allow physicians to convert their speech into readable text. Make sure you speak with your EHR vendor to ensure that they can incorporate this text into the EHR software easily, and that the data is safeguarded and protected appropriately in compliance with HIPAA rules.

Patient portals

Besides smartphone apps, patient portals are also becoming increasingly popular interfaces for practices. Patients are beginning to gain access to parts of their medical records through a Web interface with the EHR software; they are also increasingly able to input insurance information and demographics, schedule appointments, and email questions to providers. This can help your office improve front office efficiency and reduce time spent answering phone calls from patients for common inquiries like prescription refills and routine clinical issues. Patient portals are also an optional objective contained within the meaningful use rule. If you are interested in applying for EHR incentive funds, you should begin investigating whether a patient portal is right for your practice.

Tech support

Once your practice has identified whether other applications are relevant for your practice and EHR, it will be important to determine who to turn to for technical support. Your software vendor should always be your first communication line. If your system crashes or goes down for any significant period of time during office visits, you should know who to contact immediately. Likewise, if any power outages or Internet problems arise, make sure you have your service provider’s contact information available. Contact information should be posted at every computer terminal and all staff members should be trained on how to react during system outages.

In addition to your software vendor, the federal government is also creating a new outlet for EHR technical support. Regional Extension Centers (RECs) were authorized through the Health Information Technology for Economic and Clinical Health Act (HITECH), and they are designed to support health care providers with EHR implementation. Though RECs are only beginning to provide technical assistance to medical practices — especially primary care offices — it may be worthwhile to contact your local REC to see how it can best assist your practice with its HIT needs. A REC exists in each state; you can search for your state’s specific center here. You can turn to a REC for help with training and support as well as technical guidance and assistance.

After you have integrated additional applications into your system and determined a course of action for technical issues, your practice should be well on its way to a successful EHR implementation. Productivity and efficiency may go down for a short time during this transition but these levels should increase in subsequent months. Track your practice workflows again and match these up with what you had envisioned when you began this process. Keep in tune to how your practice is reacting with all these changes as well as how you can gain benefits from your EHR. Always remember that your implementation is only as successful as you are willing to make it.

This article originally appeared in the December 2010 issue of Dermatology World.