Do not allow your staff to pick the EHR. This may be the most important take home message from this book! What you ask?…. this is sacrilege. Every other self help guide says get staff involved in the selection process early. Yes and no. Staff and physicians have different needs and wants. Not all EHRs are equally good at charting as they are in front office functions.
Slick scheduling and front office workflow functions will be very appealing to staff – where they spend the majority of their time in the application. Physicians, on the other hand, spend the majority of their time in the Chart where HPI, diagnosis, orders, and e-prescribing (CPOE) must be fast and efficient. Many EHR installations have failed because the physicians delegated the important task of the EHR selection to the CFO, office manager, or staff without understanding the full impact of a second rate charting component on usability and speed of documentation.
EHR Selection Process
Think about this. If one EHR excels at charting – perhaps improving a physician’s efficiency/productivity by 5%, while at the same time, suffering from a less elegant front office interface – let us presume degrading the efficiency of the nonclinical staff by 5 or even 10%, which EHR is the better choice? The calculation is pretty straight forward. A physician’s time is worth a minimum of $300–$400 per hour; some specialists double or triple this.
The front office staff are a cost center averaging around 3 FTEs per physician at an hourly rate of $15–$20/hour. That said, it is important to explain the rationale behind your decision making to your staff and it is critical to involve them at every level for a successful implementation.
If you ultimately select the best “Charting” solution rather than the best “front office” solution, your staff, at first, may be a bit resentful. If the better charting solution improves practice income as advertised, why not reward loyal staff who contributed to a successful roll out with some form of profit sharing?