Reading bits and pieces of information from the internet and different viewpoints, it is quite evident that HIT implementation in a acute care hospital is not the same as implementing EMR for a physician's office.
Interestingly there are around 400 vendors( about 70 certified ones) for EMR. The average de-installation rate is close to 20%
While it is important for an EMR vendor to have a strong customer base and financial resources to keep updating features, it is important that they have the consulting skills and be able to help their clients derive business value from their IT investment. However smaller vendors have attractive pricing policy to compensate for lack of competencies.
EPIC systems for example is a product developed by the vendor internally and not put together through an acquisition plan. This gives them an advantage in terms of application lineage. It allows them to create lite version of the product to cater to a better range of customer needs.
According to Fox Group, 8 critical functions for a physicians office are
- Physician Inbasket
- Medcial Assistance Inbasket
- Patient scheduling
- Patient Check In
- Encounter documentation including workflows. CPT and DRG coding support
- Patient Check Out
- BIlling and Collections
- Patient Portal, reports etc
Moving from paper to computer is an important transition. Meaningful use increases in functionality and sophistication over period of time. Shift in incentives includes incentives payments, possible government financing. In order to have a operationally efficient EMR system and a "meaningful" the following are good steps to follow
- Observe a due diligence
- Assess operation consequences including changes in workflow
- Have a implementation plan and a team to carry it out
- Anticipate and handle disruption during implementation and conversion
- Balance between features. Dont overpurchase or be limited
- Get it right the first time is critical.
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