Self-assessment for practices considering electronic medical records

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Bever J. Self-assessment for practices considering electronic medical record systems. J Med Pract Manage. 2007 Sep-Oct; 23(2):80-3.


The article describes one consultant’s (no references) view of EMR implementation in medical practices and the need for practice “self-assessment” prior to doing so.


The article lists many of the recognized benefits of electronic medical record (EMR) systems: cost savings, space re-allocation opportunities, potential staff reductions, increased staff efficiencies, and remote record access. It also recognizes the significant capital investment practices must make to implement an EMR system and the need to know if one’s practice is ready to successfully implement an EMR system.

Consequently, the author provides a useful outline of potential pitfalls in implementing electronic medical record systems, and poses nine "self-assessment" questions that need to be addressed early in the planning for EMR adoption. These self-assessment questions are designed to focus the medical practice on achieving the following PRIOR to EMR implementation: unanimous physician commitment and participation, presence of a skilled project manager, a technologically savvy office staff, staff readiness and acceptance, updated staff job descriptions, uniform physician workflows and "macros" in charting, regular and on-going communication, implementation strategies for scanning and archiving, and operational practice efficiency.


The author suggests that if less than half of the self-assessment questions are answered affirmatively, the medical practice should delay EMR implementation and conduct further self-assessment. Further reflection and self-assessment also allows the practice’s members to further define why they really need, and the features they want, in an EMR system. In the process of doing so, they usually become more educated in the EMR vendor selection process which ultimately contributes to a more a successful system selection and implementation. Not addressing these issues up front usually leads to suboptimal EMR adoption, a failed implementation and/or a poor return on investment.


The author's suggestion that if there are four negative responses to the nine questions posed in the article that the practice should “take a step back” and conduct further self-assessment is anectdotal. This threshold is seems arbitrary, is not scientifically referenced, and totally unsubstantiated. One could argue that if just one of the pitfalls (e.g., not having a skilled project manager), let alone three more, could doom an implementation. Nevertheless, the author’s recommendations that practices considering a EMR system conduct an introspective assessment of their workflows, lines of communication, personnel readiness, and commitment to the implementation are important.