How to Prepare Your Team for EMR Implementation

Getting staff on board may be the most challenging part of technology change, but change management principles can help counter resistance.Electronic medical records systems are designed to make practice management easier. By automating, streamlining, and centralizing many of the dozens of administrative tasks staff members must attend to on a daily basis, an EMR system can significantly enhance your staff’s efficiency, freeing them up to focus their efforts on more critical matters.

As such, many medical practice managers are surprised to encounter resistance from their team members when the subject of EMR implementation is broached. Although a successfully implemented EMR system would likely lighten the load of most employees’ administrative duties, it can sometimes be difficult for team members to look past the difficulty of learning a new platform.

It’s human nature to resist change and to express a preference for sticking to the way things have always been done. If allowed to fester, staff resistance can torpedo even the best-planned EMR implementation effort.

According to a study conducted by executive search firm Korn/Ferry International, one of the most common mistakes that executives make when implementing a change is failing to understand the way the proposed change will impact the existing organizational culture. In order to overcome staff resistance, it’s vitally important to plan and execute a major change in a way that is sensitive to and reflects the team’s unique dynamic.

Planning is the Key

Taking the time to properly plan a project can help to avoid having to pull the plug completely on an EMR system, an outcome that can have serious financial consequences for a medical practice.

A useful tool to employ in making any significant transition is the concept of change management, which is essentially making changes in a planned and systematic manner. The ten fundamental principles of change management can easily be adapted to guide the implementation of an EMR system.

•Address the human side of technology change. Inevitably, a major technology change means that employees’ roles and duties will also evolve. It is likely that this will cause anxiety and trepidation among staff members. Tackle these fears head-on with clear, comprehensive, and compassionate explanations of the changes at every juncture in the process.

•Start at the top. It’s important for key staff, including the physicians and administrators, to be on board. A physician “champion” is needed — one of the doctors with a strong commitment to see the project through to the end, preferably someone who has skill with technology, but who is also realistic and not overly optimistic.

•Involve every layer. Everyone in the organization needs to feel that his or her contribution is important. Form a committee of employees to evaluate different systems and let them make proposals to the physicians based on their findings. The committee members should be the people who will actually be using the system: administration, business office personnel, and medical assistants.

•Make the formal case for change. People will always question the need for change. Have a written vision statement. You need to be able to explain to the organization the what, how, and why of the change effort. Prove to the skeptics on your staff that an EMR system is better than the existing paper process—or else it won’t be used.

•Create ownership. Appoint leaders who will have ownership of the project: they have more credibility with their subordinates than the doctors. Train these core people first, and then assign them the responsibility of training the rest of the staff.

•Communicate the message. Keep channels open. Encourage constant feedback. Lay out a plan and sequence of action. Keep staff informed and involved in the process.

•Assess the cultural landscape. Identify core values, beliefs, perceptions, and sources of resistance. People get set in their ways: focus on persuading the employee who doesn’t know how to use a mouse or the doctor who can’t check e-mail.

•Address culture explicitly. Take baby steps if necessary — people should gradually learn to use a computer, a mouse, e-mail, and more sophisticated programs like practice management software (EPM), then finally EMR. Keep the less enthusiastic physicians involved; otherwise, they’ll likely be resistant.

•Prepare for the unexpected. There will be problems. The landfall of Hurricanes Charley, Frances and Jeanne resulted in a changing target for our “go live” date of conversion to the new system, with significant ripple effects which were manageable largely because of proper planning and flexibility by our EMR committee.

•Speak to the individual. Be clear in what is expected of each person. Be confident, but not unrealistic — allay employees’ fears, particularly when there are problems or setbacks in the change effort.

Many “failures” of EMR systems have as much to do with poor planning and implementation as with deficiencies in the software itself. This is especially true when it comes to the changes that occur on the human side. Planning how a new EMR system will integrate with your organizational culture before actually installing the software will be time well spent and, ultimately, will benefit the bottom line.