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EHR implementation requires embracing technology


The author's first step into beginning the journey into the new world of the electronic health record was to buy Windows for Dummies.

My first step in beginning the journey into the new world of the electronic health record (EHR) was to buy Windows for Dummies. All of my previous computer skills were learned from my eldest son-7 years old at the time. I figured that a little outside education was needed.

After a little help from my 7- year-old son, I was able to log on and start "playing." I never really understood how cursing, banging my head on the desktop, and the renting of my garments was considered "play." I had one of my first revelations. If my son can teach me, why not ask someone who went to 16-plus years of schooling to help me? Our tech support team came to my rescue and, standing behind me like I was turning the first pedals on my Schwinn, they pointed out the obvious clicks that even a child would know.

Once I had progressed past the initial "deer in the headlights" phase, I started to see how cool this new system was. I could pull up my labs without getting paper cuts, order tests without having to get my medical assistant, retrieve emergency department and hospital reports in seconds instead of hours, and, OMG, I could read my previous notes!

A few weeks in, during a patient visit, I also discovered how powerful a tool this could be. One of my patients requested a new med. Some would call it a lifestyle medicine, but being a sports fan, I call it a BPED (bedroom performance enhancement drug). Anyway, as I was entering the medicine into order entry, the computer stopped me with one of those, "Hey, Dummy, what are you doing?" alerts. With my new-found humility, I never ignored these. It turns out this patient had been prescribed a medication by another provider that was contraindicated with the BPED. It was a new retroviral agent, prescribed by his infectious disease doctor, that I didn't even know he was taking. I had no clue the patient was on this medication because he forgot to mention it at the drug reconciliation. In the old paper world, he would have gotten the prescription without a second thought, with potential disastrous consequences. A new revelation: patient safety! This thing can help protect my patients! I was now turning into a full-fledged e-care cheerleader, and I figured it was now time to take the show on the road.


We were the first office to go live with our EHR. We are part of Sentara, a large multispecialty group, and many of our offices were getting ready to follow our lead. Our tech support was excellent, and the preparation they provided was a key to our success.

Bert Reese, chief information officer at Sentara, had put together an innovative approach to our new EHR. Physicians and other healthcare professionals were involved for years prior to our first go live. Physicians were asked to screen various EHRs to get their input, and they overwhelmingly chose one vendor. A physicians' advisory group was formed to get input on the implementation and help with the build of the new system. Staff were sent to each office to help with the go live.

Having someone behind you when you are trying to figure out how to order an ear irrigation (it's ear lavage!) is critical. Another new innovation that Bert did was to hire clinical personnel and train them in the technology instead of just sending tech people to our practices. Coming from a medical background made all the difference in the support and training the clinical personnel gave us.

With my new excitement for e-care and our EHR system, I decided to put together a presentation to take to the other offices going live. I figured it would be nice for the other providers to hear from someone who stepped into the ring with the beast and came out embracing him!

My presentation was called "Surviving and thriving in the new EHR." I let the providers know that they, too, could survive the EHR implementation and even thrive in just a few weeks. I gave them some tips I learned as I went along, and I explained the positives of this system. When you are looking at a daunting new system, it's easy to get bogged down in the little things and forget how powerful a tool this is and how much it is going to help the physicians and patients in the long run.

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