Self-assessment

Before selecting a HIT product, use this part of the site to assess the needs and status of your practice. Understand your workflow, staff and budget.

Consider the following factors for your practice: cost, technical requirements, workflow change and cultural change. Compare these factors to your practice's specific needs and capabilities.

Cost:

• The average cost of an EHR is estimated to be $30,000 per physician.
• The average maintenance of EHRs is estimated to cost between $3,000 and $15,000 per year.  
• You may need to pay your staff overtime as they work longer hours during transition.
• You will lose productivity and reduce patient volume while you’re adjusting.
• Customizing your EMR — getting necessary interfacing software for your existing HIT, or customizing templates — may cost you extra.
• Purchasing necessary hardware to support your software is expensive. 
• ROI shouldn’t be expected until many months down the line — potentially over a year into your transition.  

Look carefully at your budget and plan rigorously for potential pitfalls. With careful planning, the cost of HIT won’t outweigh the benefits, but without planning, cost may defeat your efforts.

Technical readiness: 

• Be aware of your staff’s level of comfort with technology. 
• Make sure that everyone in your practice has done plenty of trainings, run-throughs and is comfortable with “model” patient encounters. 
• Gather information about the new hardware and infrastructure you will need to use HIT effectively (high-speed internet connection, adequate hard-drives and back-up systems, PCs for necessary workstations, etc.). 
• If you don’t know the first thing about hard-drives and bandwidth, read-up and ask questions. (See our HIT reference section for places to find more information.)
• Make sure you have interrogated your potential vendor! Use their expertise. Take advantage of site-visits, presentations and trainings.
• Once you have the technology in place, conduct plenty of task trials, walk-throughs and model visits. The more time you spend with your new technology, the easier your transition will be.

Remember to be patient and open to learning. You won’t be able to maximize these exciting technologies unless you are comfortable with them!

Workflow analysis:

• Ask everyone in your practice to make a list of their daily tasks and duties. Ask them to identify which tasks are tedious or repetitive, and then rank them by complexity.
• Make a master list of everything your practice currently does on a daily, weekly and monthly basis; use this list to evaluate the software.
• Calculate completion times for each task; understand which tasks could easily become electronic.
• Identify if new tasks will be required with the new system, and who will take care of these new tasks.
• Create diagrams of how information flows throughout your practice. With an EMR, everyone has access to patient records simultaneously. How will this change the flow of tasks from person to person? Will some tasks become obsolete?
• Conduct a few model patient visits. Identify snags and slowdowns — walk the charts through each handoff and document where modifications are needed.

Keep in mind that you're adopting HIT not to replicate your old methods on a computer, but to make your methods smoother, richer and more efficient. See our tools section for help with analyzing and designing workflow. 

Cultural change:

• Make sure you have a plan for working with staff and patients. 
• Consult your staff about what they need, what they want and what they are afraid of. Make sure everyone knows their work won’t become obsolete.
• Assign a person to keep tabs on the climate of the office. Check in with this person regularly.
• Train your staff to respond to patient questions, complaints and concerns. Inform patients about what this technology can do for patient care. Get them excited about the change.
• Plan for ample training and hands-on learning, so that everyone is comfortable with the technology.
• Plan for slowed processes, and be prepared to be patient as adult learners adjust.
• Make sure everyone in your practice reaches a certain comfort level with the new HIT so that you can attend to patients appropriately, without technology getting in the way. This technology should enable care, not interfere with care.

Switching to HIT gracefully and efficiently can be done, but it requires self-awareness. If you spend enough time in the self-assessment stage of the selection process, the transitional stages will be much easier than if you proceed with a trial-by-fire mindset.