Investments in electronic medical record (EMR) systems are on the increase worldwide, fuelled by the promise of cost savings, improved workflow, potential for drug discovery through collaborative and multi-disciplinary cross-disease research, and improved patient care. Implementation of EMRs is a complicated process, encompassing numerous challenges: cost, existing infrastructure, multiple products, vendors and applications, scalability needs, legal requirements and user buy-in. Impartial guidance on implementation of EMR systems seems hard to locate, which may account for the fact that close to 50% of implementations fail, causing significant financial losses and other organizational and personal anguish (Keshavjee, 2006). In Ontario, Canada, hospitals have developed at least nine different internal EMR systems, and scores of subsystems that have been developed in labs, pharmacies and clinics. Ontario physicians use at least 20 difference electronic records systems – many of which are incompatible, because of commercial competition between system vendors (CMAJ, Mar, 2010). This makes the goal of integrated care and other potential benefits of EMR extremely elusive.
Today I came upon one of the best guides on implementation of the Electronic Medical Record (EMR) I have seen yet. It is entitled: Electronic Medical Record Implementation Guide: The Link to a Better Future, 2nd Edition, and is downloadable in pdf format. The document is produced by the Texas Medical Association and published by The Physicians Foundation. Three continuing medical education (CME) credits in ethics and/or professional responsibility education are available for the material in this book (effective Sept 2009 to Sept 2012). Although this book covers many issues pertinent to implementation of the EMR in the United States – (i.e. discussion of the American Recovery and Reinvestment Act [ARRA]), this is an excellent resource for all physicians, practice managers and administrators considering adoption of an electronic medical record system anywhere in the world. It offers guidance on conducting needs assessments, vendor contract issues, open source software, legal considerations for utilizing technology and steps for selecting, implementing and maintaining an EMR system.