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Tech Talk: The lowdown on high-tech

Guide to implementing an electronic medical records system


March 2, 2015
By Christina Prokop

In today’s business environment, going paperless is no longer just an option; it is inevitable. With the acceptance of this new reality, a comprehensive understanding of the existing options for electronic medical record (EMR) systems  must follow. Creating criteria for the implementation of an EMR system into your practice is equally as fundamental as the act of going paperless itself.

There are two basic types of EMR software: cloud-based and server-based. It is important to know the strengths and weaknesses of these two systems when determining which of these two would best serve the interest and requirements of the practice.

Cloud-based technology involves an easier start-up process, as it does not require any hardware installation. The upfront cost for this type of software is typically lower. The use of the technology is dependent on the user’s Internet connection – without Internet connection, users are unable to access their data.

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Client data in a cloud-based environment is stored on the software vendor’s server. This becomes tricky if, for some unforeseen reason, the vendor goes out of business. The question then becomes: what happens to the clients’ data?

It is in the best interest of the user or client to set clear terms in the service agreement regarding data ownership. This agreement will be beneficial especially in the event a chiropractor leaves his or her current practice, and prevent disadvantageous circumstances and legal ramifications that could arise for both the client and the EMR vendor.

Server-based software, on the other hand, is installed on a client’s server or designated computer acting as a server. This is often the front desk computer, also used for the practice management interface. Because the client owns the server (not the vendor), the client owns the data. As the clients own the servers containing their data, backing up those servers and testing those backups also become their responsibility.

A professional practice management software company typically offers initial consultation regarding the client’s existing hardware – asking about computer specifications, even advising against unnecessary hardware purchases.

Just like with a cloud-based system, clear terms about ownership of data should be set in place from the beginning, so in the event a chiropractor leaves the practice, he or she should be able to have their own data extracted and converted in order to move forward with the next step in the doctor’s career.

Successful implementation
Often, implementation of an EMR system will coincide with making significant improvements, upgrades and changes to the administrative structure and environment within the practice. Following are some elements that will contribute to a successful EMR adoption and implementation.

Identify the team leader. Designate a staff member, an individual with leadership skills who will move the implementation forward. The team leader will be working directly with the EMR vendor’s account manager throughout the transition. Clear lines of communication are essential in order to put forth the goals and expectations of the practice in relation to the implementation of a paperless system. The vendor must be able to provide the client detailed project scheduling and ample resource management.

Take time for training. Using an EMR system will require a change in the way things are done. Be ready to adapt to the change. Embracing the new system will allow the practice – and its users – to optimize efficiency and offer increased level of customer service. It is imperative to learn the selected EMR system’s capabilities and take advantage of the software’s features to make the practice run more productively in a paperless environment. Bring your team together and invest the necessary time to help them learn the new system. Make sure training opportunities are as abundant as possible. Consider the “train-the-trainer” scenario, bear in mind this person may or may not also be the team leader. Ideally, the staff would be trained within a two-week period prior to the “go-live” date. This way, the information remains fresh in their minds. Avoid allowing the users or office staff to learn the system on their own time. Doing so would run the risk of them not embracing the change in a manner in which you had anticipated.

Set realistic goals. If there is more than one practice management interface being implemented – such as scheduling and billing software for the administrative staff – consider the complete integration of one program at a time. A phased implementation is usually best. Create an implementation schedule with the assistance of your designated vendor account manager. It may not be necessary for all practitioners to be using the EMR system immediately. This will vary by practice. It may be wisest to implement change gradually, one practitioner type at a time, although this too may depend on your goals, desired time frame and the existing structure of your practice. Again, a plan that is clearly defined is one that will most likely succeed. Ask yourself a few fundamental questions as well. Is there any dysfunction in your team? Should this be addressed prior to attempting an EMR implementation?

Choosing the right vendor
To select the ideal software vendor for your practice, you must define the criteria for your implementation by asking clear questions to ensure the system is the right fit for your practice and your requirements.

  • Is the program cloud-based or is it locally installed?  
  • What sets this product apart from its competitors?
  • Will it provide free hardware consultation?
  • Can it offer a demo for each program of interest?
  • Does it charge for extraction as well as conversion of your existing data?
  • Is it abiding by the requirements set out by your governing body?
  • If cloud-based, will your data be stored in Canada?
  • How extensively is it able to customize the program to accommodate the methods you practice?
  • Is the software mobile friendly? Which mobile devices is the EMR software compatible with?
  • Is the vendor able to assist your team leader with the transition?
  • What is the timeframe for transition?
  • Is the vendor open to feedback?

Aside from asking all the pertinent questions, it is also important to do your own research. Check for references, talk to your colleagues about the EMR software they’re using and, if possible, visit their clinics and see their EMR system in action.

The world of health care is rapidly evolving. The electronic gathering of patient information is pre-eminent to the advancement of the chiropractic profession. The aggregation of EMR data will further expedite the discovery of positive outcomes.


Christina Prokop is a consultative account manager at MRX Solutions, a practice management software company established in 2001. Connect with her at cprokop@mrxsolutions.com or through the company website www.mrxsolutions.com


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