Implementing an EHR: Preparing for launch

To give you more than an academic answer to these questions, The Connected Physician has begun following three small and medium-sized practices through the process of installing and learning how to use an EHR. Throughout the year, we'll take you behind the scenes-up close and personal, as they say-to monitor what's going on and how everyone in the practice is reacting to the changes. In this article, we'll look at how the practices are preparing for implementation and what their expectations are. In the next TCP issue, we'll revisit the same offices to see what problems they encountered during the "go-live" phase and how they addressed them. And in one of our fall supplements, we'll see how the practices are coping with and benefiting from their EHRs six to eight months after they turned them on.

The three practices we chose for our "reality show" are Barnegat Geriatric Center in Barnegat, NJ, a solo internal medicine office; Merrimack Family Practice in Tewksbury, MA, which includes four family physicians and three nurse practitioners; and a three-site practice based in Plainfield, NJ, that includes a cardiologist, two internists, and an NP.

Now that we've seen what characteristics these practices share, let's take a close look at what makes them different, and how that affects their approaches.

Barnegat, NJ

Internist and geriatrician Harjinder S. Bedi of Barnegat has decided to plunge into his new Practice Partner system with both feet. On Feb. 12, this intrepid older physician and his equally courageous staff will turn on both sides of their integrated EHR/practice management system, and Bedi will begin documenting most patient visits electronically from Day One.

One reason why Bedi is so confident is that he's been on the cutting edge of technology for years. He accesses his medication lists online from the OnCallData e-prescribing service; he views hospital reports online; and he has a vital signs machine and a digital ECG device, both of which will be interfaced with the EHR. Another reason: he's just hired a young physician who used an EHR in her residency, and he expects to lean on her expertise.

Bedi's office manager, Pat Cea, also knows her way around computers and is working closely with Practice Partner to prepare for the launch. During November and December, she spoke weekly with a vendor representative who guided her through the configuration and the use of the system via telephone and web tutorials. Practice Partner trained Bedi and the staff on site for three days in January. (During that period, the office shut down completely.)

Bedi isn't worried about losing productivity during the launch phase. For one thing, he points out, his new doctor won't be too busy, so she can take up the slack while he learns the system. But his real ace in the hole are his three unusually helpful medical assistants, who, he says, "are ready for change."