EMR Selection: Physician Champions
Single Vendor vs. Best of Breed for Ambulatory EMR Strategy

EMR Selection: Roles of Project Team, Project Manager and Decision Making Process

  

Selecting an EMR: Ready, Set…Go Compare!  is a series of blogs that serves as a resource for physicians who have decided to select and implement an ambulatory electronic medical record (EMR).

 

 EMR Project Team:

The implementation of an ambulatory EMR requires expertise and effort from a variety of individuals within the physician's practice.  Knowledge is needed for all of the processes used in the practice on a daily basis such as telephone answering, message taking, appointment scheduling, check-in processing, weight and vital signs recording, history-taking, encounter documentation, medication administration, referral management, discharge instructing, billing and check-out processing.  Establishing an EMR project team will help bring this collective set of knowledge together.  This is important because the initial goal of the EMR project team, even before selecting and implementing an EMR, will be to clearly understand why the practice is going to implement an EMR and how it will impact all areas of the practice.  Once an EMR product is selected and purchased, the focus of the team will naturally shift to the successful implementation of the selected EMR.

The EMR project team should include a physician champion, a project manager who leads the team and a broad representation of the office staff and clinicians.  At a minimum even a small office should include an office manager, nurse, physician and a representative from the “front” and “back” desks.

Creating a multidisciplinary EMR project team such as this will:

  • Foster a team-oriented environment from the start
  • Energize the staff
  • Create a natural means of good communication
  • Promote trust, “buy-in” and support from all areas of the office

The concept of a project team and adherence to project management principles may be new to the physician and to the office staff. They may not at first understand the purpose of following structured project management principles and they may feel that it is excessively rigid. However, during the EMR implementation the value of adhering to project management principles will become apparent when the team finds itself working harmoniously toward the same vision and a common set of goals. The team should therefore be educated about how project management principles provide the structure and means that foster:

  • Clear expectations
  • Realistic timelines
  • Responsible management of costs (including the cost of staff time and effort)
  • Proactive management of bottlenecks
  • Effective decision-making
  • Effective communication

Project management plans and principles are described in more detail in “EMR Selection: Developing a Project Plan and Adhering to Project Management Principles” (next week). 

The Project Manager:

During the selection and implementation of an EMR the practice should identify a single person to develop and coordinate the EMR project plan. The options for physicians are to:

  1. Manage the project themselves
  2. Assign management to someone else in the practice
  3. Hire an outside IT consultant as a project manager

Before deciding to take on the responsibility of project management themselves a physician should consider carefully the amount of time and effort that this will involve. It is the opinion of this author that the physician champion should not serve as the project manager who is responsible for creating the project plans and coordinating all of the selection and implementation activities.  Assigning project management to an internal staff person may be considered especially if there is a trusted person with project management experience. It is the opinion of this author that physician practices strongly consider using a consultant experienced with EMR implementations and project management. Some responsibilities of the project manager are to:

  • Develop the project plans and project timeline
  • Identify tasks and available resources to do the work for each task
  • Assign responsibility for tasks to individuals
  • Monitor progress on tasks and progress on the timeline
  • Manage project issues and project constraints that develop
  • Coordinate communications within the office and among the vendors
  • Coordinate demos, site visits, phone calls, travel arrangements
  • Document meeting notes, phone call conversations, decisions made, action items and follow-up
  • Create the EMR functionality scorecard, RFP and other documents
  • Coordinate implementation activities with the EMR vendor
  • Follow project management principles to keep the activities aligned with goals
  • Coordinate contract negotiations
  • Work closely with the physician champion
  • Lead the EMR project team meetings

Coordination of the activities of a comprehensive work flow analysis and documentation of the practice’s requirements for an EMR will be time-consuming for the project manager early in the EMR selection process.  Developing a shared implementation plan with the EMR vendor and coordinating the execution of the project plan will be time-consuming later in the project.  

Decision-Making:

As the project manager, physician champion and EMR team are established there needs to be clarification about how decisions will be made going forward. Trust and support are strengthened by a clear and transparent decision-making process. The best practice in project management is to designate a single stakeholder who has the authority to make final decisions during the project. This is usually the physician champion or other lead physician in the group. At the beginning of the project everyone should be informed on how decisions will be made. The stakeholder most commonly will delegate day-to-day decision-making to the EMR project team which includes the project manager and the physician champion. Through regular progress reports the project manager should keep the stakeholder aware of all strategic decisions and other important decisions being made.  If a consultant is managing the project they should also follow these basic project management principles.   

When the project team cannot reach consensus on a decision the stakeholder serves as the escalation point.  If the stakeholder is unsure about a decision that has been made or is presented with an escalated issue that requires a decision, he/she should seek the perspectives of the individual project team members, IT consultants, EMR vendors and others in their practice who can provide valuable insights that will facilitate a good decision.

 

EMR Selection Guide provides an outline of additional topics on the selection process

 EMR Implementation Guide provides an outline of topics on the implementation process

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