-           Planning all the phases and steps.

-          Purchasing the most suitable equipment.

-          Highly focused staff training.

All of the above mentioned issues are important but most of the things also depend on the nature of the medical practice and the size. We will discuss the above mentioned step in details

First of all, keep in mind that the EMR system is a huge database of patient records including various categories related to the patients’ information. These categories are all interconnected with one another and some of these categories are medications, treatment, allergies, drugs and doses and patient history etc. Let us discuss the EMR planning and step by step implementation with the help of an example. Once the EMR software is installed on the system the data entry or record entry must be done step by step. The most important and necessary information must be entered with priority and then the less important information. Plan at each level and phase and everything will be easy.

Secondly, it is important that you should have adequate equipment before implementing the EMR such as various useful devices such as Scanner which will be used for data recording and building the EMR database. Most of the devices available in the market also are very helpful in transferring the paper based records to the EMR systems.

Thirdly, staff training is a very important issue which must be focused by the EMR implementers such as the doctors and clinic owners. The staff people are the people who will actually operate the EMR system once implemented and they have to handle all the records with having the complete patients’ information in all the categories of the medical records. Having suitable training to use the specific EMR system implemented may increase in the efficiency and productivity with very less chance or errors.

The first reason for the necessity of the EMR implementation is the same that with the passage of time EMR will become necessary and manual systems will vanish. Various studies have shown that today the EMR is providing the best healthcare facilities and quality care to the patients with its unique technology and it happened only due to such advanced technology. The most important, confidential and high valued document is the patient chart for any medical practice and the code of conduct for the medical profession believes that the complete patient record must be kept with high confidentiality which is only possible with EMR system having electronic securities for the data. The rights of consulting the patient’s EMR must be given as needed and on the other hand, paper based records can never be safely stored as compared to the EMR.

Most importantly, with the EMR system the doctor can review the patients’ performance in cure in a few seconds only and not by reading a big fat paper file in half an hour and so he can change the medications or can suggest some more lab tests. It reduces a lot of responsibilities of the doctors and the complete medical staff involved and so there are very less chances of the human errors regarding treating a patient. To speed up the electronic recording and getting more work through it, most if the EMR software includes voice recognition to enter the data as the doctors speaks and handwriting tool through which the doctor can directly record into the EMR software with the help of some handwriting input device.

-          Put some extra effort to observe your clinical procedures and processes which are necessary to be served by the EMR system in the future and there is no choice to keep it the same. Note them and avoid the rest of the unimportant things to move as it is.

-          You can also implement the EMR systems step by step and in this way you will not feel any burden of cost.

-          Select the vendor and EMR system carefully with proper research to avoid the cost needed to select another better vendor or EMR system later.

-          Some costs will reduced automatically after the implementation of the EMR system as some of the staff members will have to be terminated and paper, coordination, mail and various other charges will not sustain any longer.

-          Be planned about the implementation and being stick to it you can avoid the cost of unplanned.

There is no doubt, that once the EMR system has been implemented in the clinic, the clinic will start growing faster. The patients will be served with less time spent on them and in more effective manner. The doctor’s time will not at all wasted on the activities like writing patient information on paper files, dealing with pharmacies and laboratories and mainly, he will be able to provide complete attention to the patients. Ultimately, a large number of patients will be satisfied and the total number of patients visiting the clinic will increase. This phase will require the clinic to grow and to enhance its practices with better options to earn as more as possible.

At this stage, it will be required to conduct some changes in the EMR system apart from the software updates only. As the practice is grown, there are more patient, more staff can be needed to handle the practice and more organization and sophisticated solutions will be required. In this regard, you must keenly review the clinical processes and procedures and talk to your vendor about some more advanced and better EMR system in such clinical condition. You may need to change the complete system such as that you were earlier using the client/server EMR system and now your vendor suggests you the web based EMR system. Have some meetings with the vendor discuss the issues with him as the issues will be specifically related to your practice and implement it again to get better results.

-          The web based EMR system can be accessed from anywhere in the world.

-          Less efforts to take care of the maintenance and management efforts as most of such tasks are managed by the vendors including system troubleshooting, support and backup.

-          Patient interaction can be embedded in the web based system and in this way a lot of burden can be decreased as many things can be operated by the patient himself.

-           Less system failure chances as everything is in control of the internet. No system failure may affect the functionality of the system and the system can be accessed using some other alternative device, even mobile.

Disadvantages of web based EMR system:

-          If internet fails, the whole system fails. The system’s only dependence is the internet. As the server and all the information regarding system is placed at a remote location and is managed through the network i.e. internet, the internet failure will be very problematic.

-          Having a vendor to take care of the remote server, data and the complete web based EMR system charges heavily sometimes and paying them often is painful.

Advantages of the client/server EMR system:

-          The client/server based EMR system is less costly as compared to the web based EMR system as it only takes the cost of a few computers and a EMR software to be installed on them and connected through LAN.

-          Its maintenance is also less costly and less painful such as troubleshooting.

-          No internet connection needed to manage the client/server based EMR system.

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Disadvantages of the client/server based EMR system:

-          With the failure of server, the complete system stops working. It happens because all the other client systems are connected to server and all the information and records are saved on the server.

-          Backup of the client/server EMR system is difficult as special arrangements are required to backup all the files ad records. That’s why, if the backup is not taken and the system fails, it will be very difficult to recover the information.

-          Time: The first disadvantage is the wastage of time in working with various things at a time. The clinic staff and doctor himself gets busier and doing other tasks i.e. clerical and administrative, the patients’ medical care can be neglected somehow.

-          Cost: The EMR system seems to be much costly in the start but that is a major cost for one time and for rest of the time period there is just a nominal maintenance cost to bear.  The cost of not having a EMR system is more than having a EMR system as there will be more staff, more work and time consumption, less patients could be handles in more time, less systematic operations and procedures.

-          Data storage and retrieval: The data storage most importantly, for which the whole EMR system is designed and managed becomes very easy with EMR system and so as the data retrieval. It is computer software which is a way more efficient in entering and searching the records of the patients than writing or finding the whole paper files.

Most importantly, the EMR system needs to have easy and effortlessly understanding features, outlook and functions to get to know it soon and perform better. Let us discuss the important factors regarding the usability of the EMR system so that the EMR vendors may take care of them in a better way to improve their EMR systems.

-          The EMR system must be user friendly, easy to understand and handle also for the people who are not much in touch with the medical profession such as a doctor’s patients.

-          All the features and functions must support the EMR system with easy to use methods and processes. A small example is that most of the important features need to have the shortcut keys to use them efficiently.

-          The important and most used features must be kept at the front or at the start and less used functions and features are kept behind.

Troubleshooting of the EMR system cannot be done in simple way and everyone is not capable of handling it. It requires strong programming and other technical skills to troubleshoot the EMR system and it also depends on the nature of the problem.  The EMR troubleshooting must also be highly efficient so that the general processes and procedures the clinics have to follow must not suffer a lot due to the EMR system problems.

The EMR problems can also be much critical and any problem which may not be a serious problem according to the software point of view, but it can be a very big problem for the doctors or some patient because the EMR system deals with the patients and their records. The problem in records or data or in the EMR system anyway can cause serious problems. So in this case, the staff and the doctors must also be a lot more vigilant to take care of any big or small problem happens in the EMR system and must inform the vendor on the first priority to clear the problem and then resume working. This is also necessary to check the EMR software after the troubleshoot because the troubleshoot may also disturb some medical records.

The EMR systems are focused according to the nature of practice i.e. cardiology, pediatrics, neurology, orthopedics, dental hence, all the medical specialties may have different EMR systems to implement. This factor may increase or decrease the cost of implementation for each practice. We will to discuss the general features which must be included in all the EMR system which can be of any practice. The general EMR system features are

-          Appointments and scheduling

-          Alerts

-          Decision support

-          Documentation and clerical operations

-          E-prescribing

-          Health maintenance

-          Interfaces

-          Outsourced billing

-          Role based security

-          Revenue information management

-          Internal messaging

-          Patient portal

-          Mobility

-          Client server/web based

All these features must also be included in any EMR system and other features can be embedded as well anytime if needed. These EMR features must be included in every EMR to ensure the best service delivery to the patients. These features are said to be the compulsory features which are needed by all the practices. The other optional features can be added according to the size of the institute where EMR system is implemented, number of people using it and other totally specialized EMR features according to specialists’ requirements.

-          Resource planning is necessary which includes the allocation of resources to all the major functions to be performed during the implementation process.

-          Some of the costs may not be uniform and can change anytime during the EMR implementation process. Also allocate some amount to such variable operation and functions.

-          You may also reject some important implementation regarding facility to be implemented in the start and during the implementation if you feel that this must also be get done. Be ready for such change in decisions.

-           You must focus on the effective and efficient implementation and in this regard, you may have to pay some extra amount which is not at all a bad idea. Think about the maximum productivity you can achieve during the process and after the system implementation.