The EHR: Realities of Implementation

By Sam Ruffing, Assistant Vice President, Clinical and IT Services, Methodist Health System

EHR implementation challengesIn a perfect world, we’d flip a switch and the electronic health record (EHR) would be magically implemented across the health care spectrum. Every user would automatically know how the software works and would consistently enter accurate, comprehensive data.

Truth be told, the EHR has its implementation challenges and a steep learning curve, but the rewards for streamlining patient care are high.

EHRs offer an opportunity to reduce confusion and errors when coordinating care from setting to setting and provider to provider. The first step is getting everyone used to navigating, entering, and reviewing data in the EHR. Overall, the goal is to make the most up-to-date electronic records available at the time medical decisions are being made to improve patient safety. A secondary goal is to analyze discreet data from EHRs that can then be used to improve care. But we have a long way to go.

The vast majority of health care systems and physician practices throughout the country are just now adapting EHRs. At Methodist Health System, we’re ahead of the curve. We’ve been ramping up with electronic software since the ’90s. We installed the EHR in our clinics last year and in our nonclinical patient settings two years ago. As we have transitioned to EHRs, we’ve learned a few things:

1.   Never underestimate the amount of effort it takes to move people away from paper.

2.   EHRs drastically change workflow at every level.

3.   For the first several months of implementation, EHRs reduce productivity.

4.   We tend to think EHRs save time, but in actuality they reallocate time.

EHRs are creating many new questions, discussions, and dilemmas within hospitals across the country. What’s more, we’re struggling to develop standardizations in terminology between systems and physicians. For instance, in our current system it’s possible for a patient to present in multiple clinical settings and receive multiple medications for the same symptom if the patient doesn’t accurately communicate what medications he or she is taking. The EHR system will help prevent those types of occurrences.

Eventually, we will be able to utilize the discrete data and integrate it into decisions support so it becomes more mature at alerting clinicians when there is a concern or question about a patient’s health. Time and patience are critical as we build our understanding of and proficiency in EHR utilization.

If an EHR implementation is in your future or you are just entering the workforce, here are some tips to help you during the transition:

1.   Understand the systems your organization is using — not just how to enter data, but how to retrieve data.

2.   Keep your brain engaged at all times. Remember, software is not infallible and does not replace human intellect.

3.   Enter quality information into the system. It’s critical to the next user, so it must be accurate.

4.   Enter real-time data. Gone are the days when we used to wait until the end of the shift to chart. It will be increasingly critical to enter data in real time.

5.   Be patient with yourself and others. Remember, we’re all learning a new skill together.

The EHR is here to stay, and I believe it will become one of the most valuable patient care and process-improvement tools available to us. At some point down the road, we may wonder how we ever worked without it.

To learn more about a health care system that’s charting the course for the future, visit


© Methodist Health System


Posted Clinical Trends