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Achieving More with Less, Practical tips for getting the most out of your EHR

Therearereallyonly two reasons for buying and implementing an EHR: either to save money or to improve care. Virtually all frequently cited benefits fall into one of those categories. Neither is easy. Neither is automatic. In the long run, attaining significant quality-of-care improvements is arguably both more valuable and more difficult to achieve.

Here are some practical tips for getting the most out of your EHR. Note that sometimes you can maximize system benefits by being more focused and less aggressive during initial implementation.


  • Have a plan. Before you go to market to buy an EHR, assess your organization and culture to determine what you want to get out of an EHR and how to get it. Keep this plan in mind during your vendor selection. Remember to update and refine it as you are conducting your implementation planning for the new system.


  • Quantify baseline levels, goals and measurement sources. For example, how many medication errors (by type, severity, etc.) do you have today? What is a realistic goal for reduction? What will be the "source of truth" for capturing the data? How will you deal with the possibility that you may be underreporting errors today?


  • "Listen" to the workflow. Close examination and discussion with medical and support staff will identify some of the best opportunitiesforimprovement. Forexample,reducing thenumberofsteps and handoffs of data betweenpeople/departmentsinvolvedinany orderingprocessnot only speeds up the process, but also reduces the risk of something fallingthroughthe cracks of the system. Not paying attention can actually result in adding work and effort that potentially impedes attainment of your quality goals.


  • Manage the scope and depth of change. Providers who initially focus on a small set of data elements and/or workflow changes — confident that they will make a difference — have a better chance of achieving quality-of-care improvements sooner than the organization that tries to reinvent itself and capture virtually all data. Such focus can generate early wins, which in turn create a more positive EHR experience and set the stage for subsequent change.


  • Stay within the capabilities of your EHR system and the resources of your organization. Not everyone has a large staff of clinicians to tailor rules, alerts, order sets and physician desktops to individual needs. For example, starting with 10 or less well-conceived and accepted clinical rules may be sufficient to achieve your initial goals.

    Overall, keep in mind that the EHR is dynamic and ever-changing. Your implementation will never really be over � you will just be moving into the next phase or evolution of the system � with continuing opportunities for quality-of-care improvements.


    Mike Cohen is president of MRC Consulting Group, a St. Charles, Ill., firm dedicated to helping health care organizations make good decisions and get more value from their information systems investments. He is also a principal in Cardinal Consulting, Inc. You can e-mail him at or visit his Web site at

    Margret Amatayakul ("Margret A") is president of MargretA Consulting, LLC, a health information management and systems consulting firm based in Schaumburg, Ill. You can e-mail her at, or visit her Web site at

    Source:  Vol. 11 •Issue 10 • Page 16, EHR Corner, Achieving More with Less, Practical tips for getting the most out of your EHR.,

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