EHR payoff depends on change management

How can you prepare your practice for meaningful use of electronic health records?

Key Points

It's important to remember that implementing EHRs is a change management project, not a technology project. Both implementing an EHR and improving operations require change-change in workflow and change in work process. But managing change presents challenges, because it is human nature to cling to the status quo and resist change, even while we complain about the status quo.


The most successful practices implement technology to achieve incremental benefits, often using a phased approach rather than a "big-bang" initiative that can be challenging to users and frustrating to providers. The following recommendations are preparatory action items that not only will improve the potential for successful EHR adoption, but increase operational efficiency regardless of future technology adoption:


Is it the EHR system or the operational improvement that drives profitability? In reality, it's both. Operational improvements usually are required before the transition to EHRs, but once in place, EHRs allow for greater efficiency. A recent Medical Group Management Association (MGMA) survey demonstrated that total medical revenue/full-time equivalent (FTE) physician after operating cost was consistently greater across single specialty and multispecialty groups using EHRs than for their peers not using EHRs.

The table below provides key performance indicators for 2009 data on primary care practices (median per FTE physician) using paper records, EHRs, or a hybrid of paper and EHRs.

Higher levels of productivity, supported by fewer staff per FTE physician, resulting in higher levels of revenue, collected faster. Only by combining operational changes with EHR implementation can a practice achieve significant improvement.

Sounds like change might be good, doesn't it? Time to get EHR ready.

The author is a healthcare consultant with the Medical Group Management Association and an editorial consultant for Medical Economics. Send your feedback to

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