1. Thomas Hess, Cathy BSN, RN, CWOCN

Article Content

Today's healthcare facilities are moving toward the implementation of electronic medical records (EMRs). As you move forward with your EMR checklist to make sure your electronic documentation meets your clinical and operational needs, define your checklist for documentation success:


* efficient scheduling module


* secure patient and physician portals


* secure e-mail exchanges


* intelligent EMR to meet the needs of all practicing clinicians and physicians in your department, as well as patients, who may access their defined information


* enhanced clinical decision and practice management tools to alert users to medication errors and adverse drug interactions and to track test results and patient follow-up


* flexible integration options with existing technology, providing interoperability within the organization, interfaces to pull data in and out of your system, and clinical and operational compliance and audit mechanisms to ensure success


* clinical and operational compliance with Meaningful Use and Accreditation and Certification Standards


* audit trail to identify who performed the documentation and what actions were taken


* robust reporting for outcomes and benchmarking.



Now imagine that your EMR is approved by your administration, your launch date is determined, and you have customized your software solution. The key to your successful implementation will be training the staff through knowledge transfer of the EMR. Planning for training is crucial. It is critical that all department personnel-from administrative staff, to clinicians, to physicians-be trained efficiently, effectively, and in a timely manner on the new system. Lack of appropriate and effective training can cause your EMR to fail. So consider the following checklist as your plan for your EMR go-live experience:


* partner with an EMR vendor that listens and understands your clinical and operational needs


* define your pretraining, go-live training, and posttraining goals


* customize your EMR and allow your staff to review the software to become familiar with the menus and workflow


* customize the templates and working documents (eg, patient education tools) used within the EMR


* map your clinical and payment rules into your templates to ensure your documentation meets your facility requirements


* identify your department's superusers; pretrain for speed and efficiency


* recognize that your staff's learning needs are unique, and your implementation program should be tailored to your staff's needs


* define your vision for your software training


* determine each staff member's role-specific documentation process (eg, office administrator, program director, clinician, physician, and technician)


* define "successful training" for each staff member's role (eg, scheduling a patient, uploading a photo, amending a record)


* work with the EMR provider to determine the best strategies for training your staff


* create a training plan with the EMR vendor and identify the space for training


* carve out classroom time for the training process


* identify the training strategy for your department including presentation methods, classroom schedules/location, and staffing


* allow your staff to utilize a pretraining system/EMR playground prior to the EMR go-live


* plan the training for a success learning experience (eg, adjust patient visits and workflow)


* review the training products and tools used to implement your EMR


* determine what training products can be revisited in consideration of any new leadership and resources available post go-live


* encourage staff feedback of the EMR process during training time and adjust workflow accordingly


* define the processes and timelines for adjustments of the staff's workflow as the EMR is integrated within the department


* refine the training program based on the staff's feedback during the training period


* ensure vendor support is available following your go-live training


* schedule your posttraining objectives early in the process.



Source: Hess CT. Process management. Last accessed April 26, 2011.