EMR requires patience, relaxed workload at first

Even though electronic medical records (EMRs) are here to stay, there always will be a percentage of physicians who are resistant to using a system and don't want to change, says Stephen Martinez, PhD, CEO of MTS Healthcare, a company in Pasadena, CA, that implements EMRs for hospitals, medical groups, and other healthcare organizations.

"Unfortunately, physicians that are not computer literate often have a difficult time," Martinez says.

When implementing a new EMR system, it is critical that physicians' workloads be reduced for a few weeks so that they have the time to improve their speed in using the system, Martinez says. "Unfortunately, practices are under financial pressure to see as many patients as possible. This often results in providers not being able to reduce their schedules after the go-live date," he says. "Ultimately, it takes even longer for providers to be able to increase their speed in using the system, not to mention the increased stress they feel in trying to use the system."

It typically takes months before physicians are fluent enough in an EMR system to see patients in the same amount of time as when they did not use an EMR, Martinez says. "The power of repetition should not be understated, and the importance of training cannot be overstated," he says. "A good trainer will recognize when a physician is having a problem learning a system during the training sessions. Ideally, the trainer should have notified the physician's superior or someone from the EMR project so that additional training or coaching could be provided to this physician."

Extreme cases might require solutions such as having the physician dictate notes to a staff member who enters them into the EMR, but Martinez says that additional person must have sufficient medical training and that can make the personnel costly. Dictating to a voice recognition system also can work, but physicians with strong accents might have trouble.

"Probably the most effective solution is to offer more training or coaching," Martinez says.