Worried About the Approaching Deadline to Adopt an EHR? Don’t Panic – Assess!

By Annie Schwain, MA, LADC, LAMFT

Still feeling uncertain about the idea of electronic health records and health information exchange? Feeling overwhelmed trying to figure out what to do? You’re not alone.

Using technology to help in caring for our clients is not new, but the mandate for EHRs certainly brings about a huge shift in both our practices and in our work with clients. While there are many benefits to adopting e-health technology, including improved workflow processes, ease in communication with clients and other providers, ability to track client progress in therapy, and improved security, it is appropriate for clinicians to have a degree of caution and hesitation in making this transition.

We spend much of our time trying to support clients in making changes in their lives, and thus we know that change is a process. The move to using or increasing our use of technology in our practices is a change that, like most changes, we may both look forward to and dread simultaneously. This change will likely lead to a shift in how we provide informed consent to our clients, how we talk with them about their care and treatment, how we document the services we provide, and how we handle confidential information. The challenge is to not let our fears and anxieties about this process hinder us so much that we can’t make progress, or throw up our hands and let someone else figure out how to solve the problem for us. When we work with our clients, we support them in staying engaged in their process and in finding their own answers to the challenges that they face. For clinicians, the journey of adopting e-health is a parallel process to that which our clients experience.

In the process of adopting an EHR or HIE, I encourage people to SLOW DOWN and spend time assessing and planning the changes they want to make and to prepare themselves to be a good consumer. What works well for a fee-for-service clinician who works primarily with couples may not work so well for the clinician that works with families / children and takes insurance. Understanding your unique practice needs and exploring what products and features are most meaningful to you will provide you with better odds of finding a solution that doesn’t simply comply with the mandate, but helps you to deliver more efficient and coordinated care. Educating yourself about the basic of EHRs and HIE will help you know what to ask about when talking with potential vendors and ensure that they are able to meet your needs.

The first step to adopting an EHR is to assess your present situation and to begin to think about what you want your end goals to be. Without taking the time to assess realistically where you are and where you want to go, you may find yourself ill-prepared and somewhere you don’t want to be.

  •  Do you just want an EHR to comply with the mandate?
  • What types of Clinical Quality Measures (CQMs) are important to you?
  • Do you want electronic billing?
  • How about scheduling, appointment reminders, and practice management features?
  • How do you want your workflow process to change (or not)?

We need to assess both our strengths as well as the things that might challenge us or get in the way of making progress.

  • How comfortable are you in using technology?
  • How much support or training do you anticipate needing?
  • What financial resources do you have?
  • Who can help you understand legal documents and contracts?

We also need to explore who and what we can use for support, both in learning the skills that we need to make the transition, and to gently nudge us forward when we are feeling uncomfortable or uncertain.

  • Who do you currently use to support your practice?
  • Do you have colleagues that are working through this process now as well?
  • Who helps you with IT issues when they arise?
  • How do you learn best?

We need to demonstrate progress towards adopting an EHR and using HIE by January 1, 2015. This does not necessarily mean that you will have a vendor selected, be fully trained, and have all of your client files transferred into the new system at the start of the year. As some people have noted, there is not presently a penalty for those not in compliance on the start date, as the goal is to take the time to find a solution that is the best fit for your practice and that will serve you well in the years to come, not to make a decision simply to be in compliance. As more and more clinicians move towards adopting an EHR, there will be bottlenecks in the adoption process as vendors try to keep up with the influx of new customers and implementation may not be able to happen “on time”. Again, don’t panic, just continue to work through the process.

So how do you begin the assessment process? Stratis Health has created a FREE Behavioral Health Toolkit to assist providers in all phases of adopting health information technology, including assessment, planning, selection, implementation, maintenance, and optimization, which can be found online at http://www.stratishealth.org/expertise/healthit/behavioralhealth/. HealthIT.gov in partnership with the National Learning Consortium also provides guidance on how to implement EHRs, including recommendations for the assessment process. More information can be found at: http://healthit.gov/providers-professionals/ehr-implementation-steps/step-1-assess-your-practice-readiness. For those that want more hands-on support, Voda Counseling will continue to offer workshops related to EHR and HIE adoption, and a listing of current offerings can be found at: http://vodacounseling.com/e-health-workshops-for-clinicians/.

Have a question about health information technology that you’d like to see answered? E-mail Annie Schwain at annie@vodacounseling.com or post it in the Linked In Group “EHR Collaborative of Minnesota”.