Small practice EHR implementation mistakes to avoid

EHR implementation mistakes can result in a variety of negative outcomes, some catastrophic some superficial. When diving deeper into the issue of implementation errors practices across all settings will run the risk of experiencing common mistakes. However, some problems that can arise during implementation are unique to a practice setting such as small practices.  

When compared to larger practices, small practices are faced with a unique set of considerations when implementing an EHR. When small practices do not pay attention to these considerations, they can fall victim to implementation mistakes. 

What are some of the most common EHR implementation mistakes made by small practices?

Workflow-related problems 

According to the American Academy of Family Physicians Family Physicians, doctors in small practices spend 51 hours in practice each week, with 24 percent of that time spent interacting with their EHR. According to the 2018 AAFP Practice Profile survey, in the average week, family physicians spend 7.3 hours on the EHR during clinic hours and 5 hours on the EHR after clinic hours.

The amount of time spent interacting with an EHR in small practices presents serious and concrete concerns given that these practices are built on a foundation of face to engagement with patients and that the workload in daily clinical activities is often centered on one or a small group of clinicians. Excessive time spent on an EHR can not only have a detrimental impact on patient care, but it can also lead to clinical burnout.  

In a recent study published in the Annals of Family Medicine. The study discussed the issue of burnout among physicians in family care. The study noted that physicians in these practices are more susceptible to EHR-related burnout due to extra time spent on their EHR. These tasks included of administrative tasks including documentation, order entry, billing and coding. 

At the planning, selection and design phase a small practice can avoid clunky and burnout-inducing workflows by selecting an EHR that offers more user-friendly interfaces and speech recognition software that can minimize the time needed for data entry. 

Vendor support and training 

For smaller practices who will likely not have an in-house tech staff or the free time to troubleshoot EHR issues on their own, choosing a vendor that offers comprehensive support and staff training can cut down woes that can occur during EHR implementation and after the go-live. 

In addition, to reduce the pressure on small practice clinicians and staff, organizations that select EHR vendors who offer quality and comprehensive user support could be improving the quality of care they offer as indicated by research which shows a positive gain in quality of patient care. Alternatively, restated practices that select a vendor whose support is lacking or considered poor can hurt patient care.  For example, according to a Black Book Market Research survey 85 percent of healthcare providers reported that patient care is substantially hindered by unsatisfactory EHR user support. 

Although many of the concerns larger practices face are common to smaller practices, small practices should pay special attention to issues related to workflow design and support and training in order to avoid potential costly problems during implementation and beyond. 

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Jeff Green

About the author…

Jeff Green, MPH, JD works as a freelance writer and consultant in the Healthcare information Technology Space.

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Jeff Green

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