Best Practices in EMR Implementation: A Systematic Review

This article describes the common success factors to implement an EMR system using information from the assessment of 50 EMR implementations. Knowing the success factors prior to implementing EMR's is critical given the failure rates of EMR implementations is nearly 50% at the time this article was written.

The methodology of collecting the supporting information was collected from 125 Medline and Google searched articles over a ten year period from 1985 to 2006. The articles consisted of EMR implementations involving CPOE, stand alone EMR’s and where physician involvement was needed.

Below is a summary of the success factors during the pre-implementation and post implementation phase. These are critical to the success of clinical systems. The more success factors met, the more successful an EMR implementation will be.

• Support from top management is important to ensure the needed resources are available and the importance of the project fits into the mission and values of the organization
• A successful project manager is needed to promote, lead, organize and motivate project participants.
• Change management techniques should be used to assess and prepare clinical staff for the upcoming EMR implementation - meaning it's important to be sensitive to the needs of clinical staff.
• Involve a broad range of stakeholders to collect user requirements to ensure a broad buy-in.
• Carefully choose software to ensure it meets user requirements and have users test-run the software prior to purchase.
• Have a plan for integrating legacy data and ensure the new system integrates into other systems such as billing, labs, etc.
• Ensure the software is user friendly with a short learning curve.
• System must align closely with existing clinical workflows.
• Recognize there is ongoing technical, training and emotional support to help clinicians understand and vent about the system.
• Physician and patient security concerns must be met.
• User groups should be available for ongoing clinician questions and training.
• The benefits of EMR's such as easy access to patient data, cost savings and reduced error rates should be communicated to clinicians.

Comments: This article provided key suggestions for increasing the odds of a successful EMR implementation by using the experience of real world EMR implementations. The article provided little numerical evidence to support the success factors.

by Jim Sorensen