How to do it ... Electronic health records

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Federal health officials are pushing for greater use of electronic health records, and they're pumping millions of dollars into the effort. Key long-term care players in the information technology realm are embracing the push. But they realize healthcare, and long-term care in particular, have a long way to go to achieve the expansive electronic documentation sought by authorities. Before you jump, or step deeper, into the EHR wave, consider these how-to tips from various experts.

1 Make sure you do an audit. "You should clearly understand how each piece of the paper record is going to be replaced and, most importantly, gain an accurate understanding of how this is going to impact your nursing staff's work flow," says Travis Palmquist, a former nursing home administrator, national sales director for Achieve Healthcare Technologies, Eden Prairie, MN. "As a provider, you simply cannot afford to add another activity or responsibility on to your nursing staff without removing something. "

2 Appoint a strong project manager. "This will be critical throughout the process of deciding what you need in the way of hardware and software, planning how and when it will be implemented, setting goals — and reaching them, troubleshooting, and generally just overseeing the project from start to finish," notes Derrin Behl,
e-charting specialist with MDI Technologies, St. Louis.
Don't skimp on hardware, he adds: "EHR is going to require substantial investment of resources, but it will be worth it in the long run."

3 Organizations should have a "top-down" mandate from top managers on down if they are serious about implementing an electronic medical records system, says Tim Quarberg, vice president of sales and marketing for OneTouch Technologies, Irvine, CA. "The organization should not settle for bits and pieces or 'parts' of an EMR System," he adds.
MDI's Behl and others, however, favor a conservative approach.
"A phased or staged implementation will be more successful than trying to change the way you do everything all at once," Behl says. "It will also help keep your staff from becoming overwhelmed and frustrated by allowing them to get comfortable with each new procedure before introducing another one."
Dan Cobb, chief technology officer for HealthMEDX Inc., Ozark, MO, agrees.
"Use an incremental approach to building out your EHR," he advises. "It is tempting to automate as much as possible, as quickly as possible. However, you will maximize success by choosing attainable projects that add value to clinicians. Build upon the success of these initial projects."

4 Taking your staff's techni-
cal acumen into account also is important, Cobb says.
"You may need to train some of your users on basic technology usage before you can realize the benefits of an EHR," he noted.

5 Be sure to assess your needs properly and then buy the right software accordingly, stresses John E. Ederer, a licensed nursing home administrator and president of American Data, Sauk City, WI.
"A provider should know what is the cause of the problem they are trying to find a solution for," Ederer says. "To [simply] computerize the problem is not a solution."

6 Using point-of-care infor-mation technology is "crucial" to adopting an electronic health record, says Gordon Cameron, president and chairman of Frisco, TX-based QuickCARE.
"The point-of-care technology will pay for the expense of the EHR as the staff becomes more efficient in capturing the data necessary for reimbursement," Cameron says.

7 Caregivers will feel em-powered with electronic tools that eliminate errors, save time, and improve communication, agrees Zoe M. Bolton, vice president of business development for American HealthTech, Jackson, MS. Care plans should be electronically linked to various triggers, she adds.
"Care delivery should be an automatic byproduct of assignments or approaches identified during development of the plan of care," Bolton says. "Assessments performed electronically link to the care plan library. Problems are selected from the library, which contains associated approaches. Those approaches automatically trigger on wireless remote data-recording devices."

Before buying in Keep these tips in mind regarding EHR vendors:

∑ Whoever you choose should stay involved at the national level, know the direction of the industry and be willing to make adjustments as governing agencies make changes.
∑ Keep presentations of competing software products close together as decision time nears.
∑ Don't settle for just a reference list. Demand a client list so you can decide whom to call.
Sources: QuickCare, American Data, 2006
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