Gary Mellon, DPM

Successful implementation of EMR involves much more than just purchasing a quality EMR software package. The following steps should be included in your process of determining how much it will cost to implement EMR in your office. According to Ken Katz, President of ICS Software, Ltd. who writes, sells and supports The Sammy Systems, these are the most important considerations:

1. Evaluation of how many computers workstations you will need in your office. This includes decisions on whether you will install computers in each treatment room, utilize kiosks that will be wheeled from one treatment room to another, or utilizing tablets that the doctors will carry from room to room. If you plan on doctors having remote access from their homes, you need to plan for secure connections from the doctor’s home to the practice.
2. A decision on whether you want to utilize wireless networking in your practice. A hard wired network is much more secure from the perspective of HIPAA and when implementing wireless networking, you will need to insure that you have properly secured the wireless network.
3. Determination of the need for remote access to the office from offsite locations such as doctors accessing the EMR from home during non-business hours, transcription services accessing the EMR to type the notes into the EMR, or billing services accessing the EMR / PM system.
4. Will your practice require a dedicated server for your network to support your EMR package? If your practice will have more than 3 workstations, you will find that a dedicated server will provide much better performance.

Include Your Staff in the Planning Process

You should include your entire staff in the process of implementing EMR, because EMR is usually much more than just EMR. Many of the EMR packages available to podiatrists include Practice Management features such as Billing and Scheduling. You need to have input from your front desk staff and your billing staff to determine what is required to insure that they can perform their job functions. Your medical staff scribes, and assistants who will be involved in using your computers should also be included in the discussions on how your office should be configured when installing the EMR.

Determine the Costs of Hardware and Software

Once you have completed this task, you need to determine the costs associated with implementation of all the necessary hardware and networking devices necessary to support your practice. This is the infrastructure that you will install your EMR on. This is a line item in your budget for your EMR

The knowledge gleaned from this process is extremely important when speaking with EMR vendors. Each EMR has its own cost structure and may be based upon the number of users, the number of workstations, or a combination of factors that will impact the final cost of your software. You need to obtain quotes from each vendor, based upon the hardware configuration you will use in your office. Most of the time, the ‘advertised price’ is based upon a single doctor in a small office, while the price you see on your quote will be based upon the needs of your practice.

Training Will Be Needed

When obtaining quotes, insure that the cost of training and how much training is included in the quote. There are times when the amount of training included in the quote is not enough for your practice. You need to insure that the cost of additional training is written into the quote / proposal provided to your practice. Above all, deal with a reputable company – one which you see at Podiatric functions.

When budgeting for training, you also need to have a line item for the salaries of your staff for the time that they will be training. The best way to determine how much this will cost is to ask your colleagues how much time it took their staff to be trained.

Hardware, Software, and Training = Initial Implementation

These three line items, the costs of hardware and networking, the cost of the software, and the amount you should expect to pay your staff for the time they spend in training, provide you with a working budget for how much you should expect to spend on initial EMR implementation.

Ongoing Costs to Run and Maintain System

Your EMR will also have ongoing costs related to support and services that are required for your practice, which can include, claims clearinghouses, e-prescribing clearinghouses, offsite backup, software support, and hardware maintenance contracts. When comparing EMR software packages, you need consider these ongoing costs when preparing your budget.

During the initial implementation of any EMR software package, there will be productivity slowdowns. This is very difficult to budget for and these slowdowns can be minimized by extensive training of your office staff prior to going live with your EMR.