Managing the Implementation

Here are some general implementation guidelines that other offices have found useful: 

1. Concentrate on implementing your staff and office first and providers second. While this sounds paradoxical it actually is very useful. Many of the office automation features that electronic health records enable will make the providers life extremely easy.
   
   The providers have a good deal of learning to do regarding working this new way in the examination room and everything can be set up to help this process ahead of time and to provide information at the time of care, things will go much smoother. So before you go live with the record everything else should be functioning appropriately including scanning, faxing, messaging and any interfaces that can be brought online quickly.
2. The providers and staff should be familiar with the hardware and the software as much as is possible before starting to see patients.

This sample implementation timeline represents a conservative guideline for a small medical office. Certainly, it can be done more quickly if desired.

Three to four months before "go live"

1. Install hardware in the rooms or purchase wireless equipment including tablets and/or laptops. Depending on your electronic record at this point you may need a server.
2. Ensure the functionality of your network and hardware and that everything can communicate with each other.
3. Install and verify your scanning and faxing capability.
4. Accomplish any basic computer teaching that is necessary and get feedback from your staff and all involved.
5. Ensure your team is working well together.

Two to three months before "go live"

1. Establish your protocols for scanning incoming information and faxing outgoing information.
2. Continue to build general computer skills and continue to receive staff feedback.
3. Install and test any ancillary programs which might either be required or be very helpful which includes speech-recognition programs, accessory faxing and scanning programs etc.

One to two months before "go live"

1. In an ideal world this would be the time that you're electronic health record software would be installed. This would allow the providers and office staff time to fully check out the system and make sure everything works. Sometimes this is not done because the teaching and installation is done at the same time by the vendor, very close to the go live day. Whatever the exact time between software installation and starting to see patients using the record a few things should be checked out:
   
   * Ensure the software and hardware function as expected. Make sure that screen transitions are quick and that there is no lag in how the system is performing. 
   * Test the interoffice messaging system and make sure you can fax prescriptions.
   * Test printers.
   * Scan some material into the record to test this functionality.
2. Decide what information needs to be put in to the patient's chart ahead of time and start doing this for patients coming in the first few weeks at least.
3. Run through some mock patients in order to get a feel for how the system is working and for patient flow through your office.