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7 Effective Steps for Implementing Electronic Health Record

Your medical practice can benefit from implementing electronic health records (EHR) and so can your patients. For those working in your medical practice, you make it easier to access pertinent information to better treat patients. For patients, you make accessing their records easier, so they can easily share them with other providers including in emergencies.

Implementing Electronic Health Record

Implementing such an EHR program can be easily accomplished. You can follow this seven-step method to establish an EHR program. A self-assessment of your medical practice provides the unofficial eighth step.

Implementation Planning

Before you begin the seven steps, you need to assess if your organization can readily switch to the use of EHRs. Do your patients and your practice need EHR? Does its implementation meet your treatment goals and business goals for your medical practice? Can you meet the financial and technical requirements of EHR, including the added HIPAA privacy and security requirements? Answering these questions lets you know if you need to proceed.

If you determine that you should move to the process of implementing EHR, you first need to decide on a vendor for the EHR software development. You won’t go it alone. Your practice does not need to reinvent the wheel. Plenty of EHR options already exist. Each one uses slightly different methods though, so you need to choose the EHR vendor before you move through the seven steps.

Rather than researching EHR programs from scratch, ask for help from an organization that has already conducted such research. Contact your Regional Extension Center (REC) for assistance in examining available choices and determining which EHR vendor would work best for you. Once you have chosen your vendor, collaborate with them on the following steps.

1. Map the current workflows used in your office. The better documented your business procedures, the easier this is to achieve. Analyze the workflows.

2. Plan the desired EHR workflows. Streamline workflows to improve efficiency and eliminate duplication.

3. Conduct a contingency planning and disaster recovery planning exercise. This develops your plans and codifies them, so you can combat issues arising during implementation.

4. Hire or appoint a project manager for EHR implementation. The EHR project manager researches and authors the transition project plan. Consider this point person the project owner.

5. Plan how you will migrate patient charts. This plan maps the transfer of paper charts to EHR. Differentiate between the items that you must manually enter and those that you can scan using OCR software-enabled scanners.

6. Consult with your EHR vendor to understand which data elements you can migrate from your current process and charts. This step provides you with a full understanding of the information an EHR can accept via your scheduling information and patient demographics.

7. Hire or appoint an individual to manage the EHR privacy and security requirements. This person must be conversant with the minutia of HIPAA, specifically its privacy and security requirements. Your organization’s current procedures to meet HIPAA requirements will not suffice. You must meet the electronic security measures which require all patient data be kept private and secure. While the EHR vendor handles part of this, your organization must all meet its burden to ensure complete privacy and security of information for each person who uses your medical facility or meets with your personnel.

Work with your vendor to develop a training program for your employees. Your vendor will have turn-key training for how its product works, but you will need to develop with them training for your internal processes and procedures and how they will integrate with the EHR software.

You should develop and conduct the training before implementing the EHR system. Once you go live in your office, you should have already trained every person who works there. You will also need to provide formal training for each new person you hire. In accordance with the law, you will need to have each employee complete the training before they start work. This ensures patient data remains private and secure at all times.

Before you switch over to the EHR system, conduct test runs of using the system. This may require closing the practice for a day or paying employees to come in on a day the office typically closes for testing the system and procedures. You would need faux patients for this stage of implementation, so you can afford to make mistakes. You cannot use actual patients because if your employees make a mistake it would reveal the actual patient data which is federally protected. Ask employee’s family members to volunteer for the pilot project. “Pay” them by holding a nice meal at the end of the day for everyone. The actual employees you will need to pay for the training. On this pilot run using faux patients and patient data, you can make mistakes and learn as you go. Have the office test run go through a typical actual day’s schedule just as if it occurred in real-time. This helps you uncover any problems ahead of time.

Work through any glitches or problems. Set your implementation date. Implement your EHR and import your data. This gets you to stage one of achieving meaningful use. Stage two occurs when you begin adding to that with patients entering the medical practice for appointments. You update their charts and continue to add to the EHR.


You still aren’t done. Using EHR requires “Continual Quality Improvement” (CQI), a phrase referring to making incremental improvements to the system. You do this by conducting regular evaluations and making improvements to the system. You will do some of this in response to compliance requirements, but you should not wait for required reviews to improve. Regularly revisiting your organizational goals and patient needs will help you refine workflows and business processes, especially as they relate to your EHR system.

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