Since EMR systems are often designed for the hospital setting, ASC administrators may face significant hurdles in implementing a system. Industry experts discuss five things every ASC leader should know about implementing EMR in a surgery center.
1. Planning for EMR implementation should start now. Surgery centers, for the most part, lag behind hospitals in EMR implementation because of financial and staffing restraints. In addition, the government has yet to provide financial incentives for ASCs to implement EMR, and there are far fewer companies that specialize in ASC EMR software. But according to Beverly Kirchner, owner and CEO of Genesee Associates, "Looking at and adopting an EMR system today is imperative for survival in 2014 and on. The data [that] surgery centers will report to CMS and [other bodies] can not be accurately obtained manually, and the hours it will take to obtain the data manually will potentially cost more than the software in the long run."
She advises ASC administrators to start looking at EMR vendors, educating themselves on meaningful use requirements, looking at the hours it will take to train staff and asking more EMR-experienced administrators about their experiences.
2. Find software that meets your facility's needs. According to Sarah Sterling, business administrator at Post Street Surgery Center in San Francisco, one of the biggest mistakes ASC leaders make in implementing an EMR is choosing a system that doesn't work for the center. "People tend to make the mistake of not doing their research and getting software that doesn't meet the needs of their facility," she says. "The research is important, so what I had done was look at different products from different vendors, demoed their products, created a spreadsheet that listed each products' best features according to their vendors and talked to vendors' clients about those products."
Since more EMR systems are designed for hospitals than for health systems, this research is very important for finding a system that works for your staff and physicians. Ms. Sterling said there may be no way of knowing how a system will function once it goes live without substantial research into the experience of other ASC customers.
3. Plan for clinical processes to slow down during implementation. According to Patrick Doyle of SourceMedical, an ASC budgeting for an EMR should also plan for a drop in caseload and productivity for a few months following go-live. This will mean decreased finances, so the budget must plan for the possibility of a few low-volume months.
He says physicians and staff members may have to take a lighter caseload during the months following implementation because registration and documentation will take longer. However, the ASC should be back to normal within a few months, assuming the staff has been properly trained.
4. Investment in EMR should pay off after 18 months. Investing in an EMR for an ASC can be intimidating, but Mr. Doyle says the investment should pay off after 18 months (assuming a license/self-hosting model, where the ASC owns the software and hardware and pays a higher upfront fee on both). He says ASCs should plan for the "hard costs" of software and hardware as well as "soft costs," including the cost of labor for three months to implement the software and some case disruption while the staff adjusts to using the EMR.
The savings associated with EMR include the money spent on chart materials, such as dividers and tabs, chart folders and covers and pre-printed forms, and money spent on document security, including shredding and storage. EMR can also save ASCs money in hours per day spent preparing a paper chart by business office personnel, including chart pack assembly, collating, document and chart retrieval, and copying and faxing. These hard and soft costs can add up to over $120,000 per year and should make the EMR a profitable investment after 18 months.
5. Avoid unnecessary human interaction with your system. Your physicians and staff members will use your EMR frequently following implementation, but according to William Edwards Jr., MD, MBA, of The Surgical Center in Nashville, Tenn., more human interaction can actually decrease the EMR's functionality. "Our epiphany came when we realized we needed to eliminate as much human interaction with the entire process as possible," he says. "We refined our goals to enable our EMR system to automatically file records without human interaction, and to tag documents with an identifier that allowed the file to be appropriately placed in the correct section of the chart."
He says decreasing human involvement made the process less error-prone. If the physician doesn't have to enter a demographic identifier and the system enters the identifier automatically, Mr. Edwards says it can't be incorrectly entered.
1. Planning for EMR implementation should start now. Surgery centers, for the most part, lag behind hospitals in EMR implementation because of financial and staffing restraints. In addition, the government has yet to provide financial incentives for ASCs to implement EMR, and there are far fewer companies that specialize in ASC EMR software. But according to Beverly Kirchner, owner and CEO of Genesee Associates, "Looking at and adopting an EMR system today is imperative for survival in 2014 and on. The data [that] surgery centers will report to CMS and [other bodies] can not be accurately obtained manually, and the hours it will take to obtain the data manually will potentially cost more than the software in the long run."
She advises ASC administrators to start looking at EMR vendors, educating themselves on meaningful use requirements, looking at the hours it will take to train staff and asking more EMR-experienced administrators about their experiences.
2. Find software that meets your facility's needs. According to Sarah Sterling, business administrator at Post Street Surgery Center in San Francisco, one of the biggest mistakes ASC leaders make in implementing an EMR is choosing a system that doesn't work for the center. "People tend to make the mistake of not doing their research and getting software that doesn't meet the needs of their facility," she says. "The research is important, so what I had done was look at different products from different vendors, demoed their products, created a spreadsheet that listed each products' best features according to their vendors and talked to vendors' clients about those products."
Since more EMR systems are designed for hospitals than for health systems, this research is very important for finding a system that works for your staff and physicians. Ms. Sterling said there may be no way of knowing how a system will function once it goes live without substantial research into the experience of other ASC customers.
3. Plan for clinical processes to slow down during implementation. According to Patrick Doyle of SourceMedical, an ASC budgeting for an EMR should also plan for a drop in caseload and productivity for a few months following go-live. This will mean decreased finances, so the budget must plan for the possibility of a few low-volume months.
He says physicians and staff members may have to take a lighter caseload during the months following implementation because registration and documentation will take longer. However, the ASC should be back to normal within a few months, assuming the staff has been properly trained.
4. Investment in EMR should pay off after 18 months. Investing in an EMR for an ASC can be intimidating, but Mr. Doyle says the investment should pay off after 18 months (assuming a license/self-hosting model, where the ASC owns the software and hardware and pays a higher upfront fee on both). He says ASCs should plan for the "hard costs" of software and hardware as well as "soft costs," including the cost of labor for three months to implement the software and some case disruption while the staff adjusts to using the EMR.
The savings associated with EMR include the money spent on chart materials, such as dividers and tabs, chart folders and covers and pre-printed forms, and money spent on document security, including shredding and storage. EMR can also save ASCs money in hours per day spent preparing a paper chart by business office personnel, including chart pack assembly, collating, document and chart retrieval, and copying and faxing. These hard and soft costs can add up to over $120,000 per year and should make the EMR a profitable investment after 18 months.
5. Avoid unnecessary human interaction with your system. Your physicians and staff members will use your EMR frequently following implementation, but according to William Edwards Jr., MD, MBA, of The Surgical Center in Nashville, Tenn., more human interaction can actually decrease the EMR's functionality. "Our epiphany came when we realized we needed to eliminate as much human interaction with the entire process as possible," he says. "We refined our goals to enable our EMR system to automatically file records without human interaction, and to tag documents with an identifier that allowed the file to be appropriately placed in the correct section of the chart."
He says decreasing human involvement made the process less error-prone. If the physician doesn't have to enter a demographic identifier and the system enters the identifier automatically, Mr. Edwards says it can't be incorrectly entered.