Applied Medical Informatics for the Chest Physician: Complexity of the EMR
The elements of achieving success in an EMR selection, configuration, and implementation are complex. The three major categories are “Winning Hearts and Minds,” “Technology,” and “Place and Time” (Fig 1). Credible leadership is essential, and, as has been demonstrated repeatedly, implementing any change in medical practice usually revolves around a group leadership model. The change cannot be achieved without involvement of these pre-EMR clinical leaders. Unfortunately, in the current health-care informatics reality in this country, there is no standard EMR, no standard EMR implementation plan, and, even within an individual commercial EMR product, no standard configuration kit. Therefore, the champions of EMR need to address the following issues. The introduction of an EMR into a clinical practice, even the smallest of offices, should be viewed as a campaign. A campaign requires some element of orientation, education, and credible leadership to achieve success. buy-asthma-inhalers-online.com
The first phase of this orientation usually involves a discovery period, necessitated by the fact that no two EMRs are alike, and, even within the implementations of a particular commercial EMR, no two implementations are exactly alike. Although most novices to this discovery process immediately gravitate toward expanding the features and functions of the EMR, I advise first seeking out clinical settings that are comparable to your own. That is, if you work at a large multispecialty community practice group, first examine EMR implementations from like organizations, rather than those from organizations the EMR vendor wishes to showcase. If the vendor does not have an implementation in a clinical setting you would consider comparable to your own, caveat emptor! As in any major change in medical practice, effective communication is essential for success as well as for achieving the necessary momentum to sustain the complete implementation of a project. In the history of EMR implementation in America, one of the most consistent characteristics of success has been the steadfast leadership and commitment to achieving a vision of effective implementation.
Figure 1. Results reporting information system. PCIS = patient care information system.