Re: Walmart Health: Just had a great dental visit this morning, which was preceded by helpful reminders from Epic, and…
Practice Wise 4/11/11
Be Your Own Consultant!
So you’re trying to convince your bosses that they need to purchase an EHR because Meaningful Use makes it so. It feels like Y2K all over again. You know, back in the day when we all used a PM system on dumb terminals (ah, but the UNIX platform was so stable!) and you had to convince your doctors that it was time everyone got a PC and Microsoft Office and the new PM software that could give you four-digit years and save the world.
Déjà vu! You’re in this terrifying role where you have to learn the lingo, understand all the bells and whistles of products that make your head spin. Then, convince a single owner or a board of partners that you understand everything you are presenting to them, and your recommendation is …
Who do you trust to educate you on all of this technology? And to help you not lose your job by making a colossal mistake and costing thousands of dollars and jobs and possibly the meltdown of your practice? I know it sounds like doom and gloom but admit it — this is the stuff that keeps you up at night.
I say trust yourself. You can hire a team of free experts, be one yourself, and thrive in this experience. Admit your terror and reach out to the other terrified individuals in your community. How? Start a user group!
- Don’t wait. You don’t have to be users of anything to start a group. Don’t wait until you get your software and then decide to start or join one. Start a group of almost-EHR users who all know a little about a lot of things or a lot about some things. Share your knowledge.
- Invite vendors to present to your group. This is easier than attracting dogs with top sirloin. Trust me, you will need to devise a method for a waiting list.
- Be selective. Even as a group of users, you don’t have a lot of precious time to waste. Research your vendors and invite those who you think will give you the best bang for your buck. Which is zero, but don’t let that be the rate limiter.
- Ask the non-EHR vendors. You know, that whole group of support consultants and third-party vendors that are like little seedlings in the spring of EHR adoption. They usually see most of the products as they interface. Better yet; they talk to the end users and hear the complaints and praise of everything. Boy, don’t we love to share our experiences with anyone who will listen?
- Give them the lunch hour for presentation. Make sure they provide the lunch.
- Invite real (EHR) users to your almost-users group. They will be your deepest resource (see above, don’t we love to share…). From them you will learn what not to do, who not to waste your time on etc. They’re like parents and you should learn from their experiences.
- Have different members of the group host your meetings. If your office won’t accommodate the crowd, check out hospital conference rooms (can be reserved in advance), the local medical society (should willingly lend to their participating providers), or the presenting vendor (don’t think of this as giving up the upper hand – you get your needs met, they do their presentation, and nobody is worse for the wear).
- Don’t limit your group to EHR discussions. This kind of change management doesn’t happen in a vacuum. Your entire practice operations are going through electro-shock therapy. Open up to the whole discussion and ways to help each other through this evolution.
- Keep it free, short, and worthwhile. You will build an amazing panel of experts that are now part of your team. The president runs the superpower of the free world and even he doesn’t know it all. He has a cabinet of experts who advise him. You can, too.
Julie McGovern is CEO of Practice Wise, LLC.
No offense to anyone, but this is the kind of generic, bland, almost useless advice that so many “consultants”(firms, organizations, websites, white papers, how-to primers, ad nauseum) give to the market.
Honestly….how much of this stuff isn’t anything more than common sense or bromides? Of course, its free in this medium so why give away anything that isn’t common sense away, right? One of the reasons nearly 50% of all EMRs purchased the past ten years were abandoned, given back or just plain were never used…is that is was either a poorly-designed product (from the PROVIDER’s perspective), or one that didn’t fit the practitioners business very well. There’s a lot of autopsy material on the failed EMR experience out there…its just not talked about within the consulting community or by the vendors themselves…the reasons why ARE pretty self evident.
How come you never see advice to practices that deals with some of the REAL advice they should get….like some of the following:
1) Make sure you get a list of AT LEAST 20 practices in the same specialty that have been successful in implementing a vendors EMR. There are literally dozens of EMR companies that have one, two or three “showcase” reference practices who will speak up for a vendor. If they aren’t in your specialty…you’re asking for trouble. A Dermatologist, an Orthopedist and an OB/GYN don’t have the same workflow or processes for documenting exams. A vendor with 500 clients may have 450 of them in one specialty. If yours is not that specialty…look elsewhere. Two or three isn’t nearly enough. They might not be anything like you and may have gotten very special treatment to make sure they were “referenceable”. You need a LOT more on that list to be sure. Tell them you want to call, say, four at random off the list…and don’t tell the vendor which ones you’re going to call. No fixing the deck that way. Odds of failure will go way down on this tip alone.
2) Don’t count on “the product demo” to clear up a lot of your confusion. The demo is probably the most over-rated of all things you can ask about. All vendors will make the product look easy. They demo it every day, several times a day. They have their process, patient data and “rehearsed” scenarios down to a science. They’ll tell its easy… once you go through their EXCELLENT training. You are swallowing the bait if you believe it. Ask how long the training is for providers…and how long it until a FULL calendar of patients can be seen every day without loss of time. After you get their answer, ask them if they will accept penalties if they dont meet their stated answer. Watch ’em run from that.
3) Certification is NOT a criteria for your selection of an EMR. Sorry…this one is important. As of today, there are over 300 EHR’s fully certified to ENABLE providers to meet Meaningful Use. Virtually EVERY EMR that applies and pays the certification fees, passes and gets certified. What kind of certification is that? Does certification differentiate between good products and bad? Does it differentiate between those good for your practice specialty and size? Does it differentiate between ones that save you time or slow you down? No…no…and no. Certification is a check box item only. Like asking if the house you’re looking to buy has water and sewers: if it does, you probably arent going to ask for a detailed demo on how that works.
Hey…I’ve got a few more that I think are really relevant and important…but I wont’ waste any more space if no one really cares. I’m not trying to sell consulting services though. Just sharing a lot of years of health care industry and problem-solving experience, for what its worth. If anyone is interested…be glad to share some other things I think are a lot more relevant to this area…..
RE: Reef Diver’s comment: #3) Certification is NOT a criteria for your selection of an EMR. Sorry…this one is important.
First off, you are coming across as an old curmudgeon, albeit most likely one with lots of good experience, you still need people to listen, not run the other way!
I would disagree with you on your comment. Certification IS a criteria for selection of an EHR if the user wishes to receive incentive dollars. Sorry, but those are the rules.
Sorry Mr. Rust Belt Fan…YOU sound like a Rules-mudgeon. “The rules is the rules” never begot much progress. Only when bad rules get broken…or at least fixed….do we break logjams. Even the Constitution had a serious flaw…and it took a Civil War to fix that one.
Quite frankly, I don’t think the incentive dollars are the most important thing on every medical providers mind. While the law IS the law, Congress is now debating whether it was a good idea during an economic crisis to offer financial incentives to some of the highest paid people—doctors—to use technology that may have an adverse effect on their productivity, could result in lower reimbursements and even higher costs to their practice. I’m answering the question, “Why is that so?”
“Certification” may be a good idea as one plank in healthcare reform. We’re still putting a huge part of the burden on providers and leaving untouched the bigger issues, like tort reform and insurance reforml…but to answer with “Sorry, those are the rules” sounds pretty lame doesn’t it? If there are a few providers or practices out there that benefit from the notions I offered, great. If not…take it for what its worth. No harm no foul.
But to be sure YOU don’t miss the real point…I’ll state it plain: Certification will NOT help any practice or provider determine which product is best for them, and itself does nothing to distinguish between strong products and weak ones.