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Running an Electronic Medical Records Simulation Day

Guest post by: Peter Polack

Article Overview: Before going live with the new EMR system, conduct a simulation day. This simulation should include everyone at the practice, and go through a day's operations in the new system.

Running an Electronic Medical Records Simulation Day

It's wise to hold an evaluative pre-launch day well in advance of the date to go live with your electronic medical records (EMR) system. The simulation should cover all aspects of a single day's operations at the clinic; this includes everything from check-in to check-out. If your practice has an electronic practice management (EPM) system in use, the test day should also measure the integration between EPM and EMR systems, including billing. Our practice put aside one single day on the weekend to have the test. With just a few exceptions, all the physicians and clinical staff were expected to be present. Office personnel helped with check-in procedure, and other employees became mock patients in the simulation. All staff members went to the place where they would start work on a Monday, including the surgery room.

The mock patients each received a diagnosis which included a clinical history. These helped us recreate a variety of processes within the electronic medical records (EMR) system. Some of the mock histories include an acute problem, a surgery, and one on a follow-up visit. By attaining this level of detail in the simulation your practice is ale to measure template effectiveness in real time.

All the locations of a multi-location practice should access the EMR software concurrently during a test. At this time, you can look for system problems while making sure the network can handle the work with adequate bandwidth for smooth operations. Do system parts crash? Are there any problems with inter-office communication? The mock patients should simply go through each of the stages that a real patient would in the same situation. The EMR system will change the office work flow in some unexpected ways. It's wise for a practice to learn this in advance of the live launch date.

At the surgery location, staff must be able to access all patients' records remotely. These scenarios should definitely be included in the simulated test day. The nurses should enter in the medical histories with laptops, and surgeons should use EMR to refer the patients' charts before selecting the lenses for surgery. The test should be performed on a monitor in the operating room as well.

At the end of the simulation, clinical supervisors should meet with the administration team. The purpose is to evaluate system performance and staff work flow. Beside a few minor problems, the entire practice received a passing grade at simulation's end. The physicians agreed that the weekend day spent at the practice was worth it - particularly when considering the relief after the build-up of stress as the launch date grew near.

Before the actual go-live day for EMR (electronic medical records) at your practice, you would be wise to perform a soft launch of the whole process. This sort of simulation should mimic half a day of operating the clinic, from patient check-in to check-out. If your practice is using an electronic practice management system, a test day can also demonstrate the proper integration between the EMR and EPM, including the billing process.

At our practice we set aside a November Saturday, listened to the groaning objections, then laid out the plan while others surveyed for weaknesses.

All Hands On Deck

Next, all hands were called to the table. With just a few exceptions, all physicians and clinical staff were expected to be present. Some of our other employees volunteered to act out the role of patients in this simulation, along with office personnel helping with check-in procedures. All the doctors and the staff members were sent to the place where they would normally be located on a Monday morning to begin work, including the surgery area.

Test Different Patient Scenarios

Our pretend patients were each given a clinical history and diagnosis, in order to recreate the electronic medical records process. Some would represent a new patient needing surgery, another someone with an acute condition, one in for a follow-up, or a check-up, for example. The variety would let us measure the effectiveness of using the different templates, all in real time.

The Entire System

All of the different satellite locations should access the EMR software simultaneously, from somewhere in a central location. With this, we looked for any system deficiencies. Would the network handle the work load? Was there enough bandwidth to keep accesses smooth? Did any machines crash or freeze?

Work Flow

The mock patients should simply act out the same routine that an actual patient would. This includes signings, requests for medical assistants, and movement through the examinations and check-out. This process will cause any work flow problems to surface, even if undetected during planning. On simulation day, many practices learn that the work flow in EMR will change in unexpected ways. The simulation day is the day to learn how so - not the live day.

Remember the ASC

Our surgery location must be able to access all patient records. These functions were included in the simulation. The nurses entered the medical histories using laptops, as patients were each checked in. Surgeons used the EMR to look at the patients' charts before selecting the intraocular lens. This test should also include a time out in the operation room, also checking the same records on a monitor.

After the Fact

At our practice, clinical supervisors met with the administration team at the end of the simulation. The purpose was to evaluated the performance of the system and the staff. Aside from a few minor glitches, the entire practice earned a passing grade.

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Article Tags: acute problem, adequate bandwidth, clinical history, clinical staff, electronic medical records, electronic practice management, emr software, emr systems, histories, inter office, launch day, level of detail, location staff, office communication, office work flow, scenarios, single day, smooth operations, staff members, surgery room



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