We now see this situation over and over again.  Single practice provider, usually a specialty practice, provider in their 50’s and having practiced successfully for 25-30 years now find themselves in danger of losing their practice.  Why?  There are numerous scenarios…..but most of them go like this.  We have had a successful and lucrative practice for many years, our business office is efficient and knows what to do…..then we had to buy an EMR and our revenue has fallen like a rock. An investment of $100,000 is not uncommon and should be absorbed as a practice expense if properly planned for and executed correctly.  So what’s the problem?

• The EMR companies are so busy selling and implementing, they do not invest appropriate time and effort into getting the provider up and going in a way with which the office is comfortable.  hint:  every contract providers sign for EMR’s should include on-site training and full service help lines.  This may cost a bit more, but in the long run, the practice will be much better positioned for success.
• The staff is inadequately prepared.  Switching from a paper office to an electronic office does not happen overnight.  And some staff may not make the transition without kicking and screaming…..and some may not may it.  That’s a difficult situation, especially for a single practice office where everyone knows each other well and many have worked in the practice for numerous years.  hint:  Preparation and training of staff should start months before EMR actually installed.  Before you buy a system get your staff ready by visiting sites in the same specialty that use EMRs.  Have meetings about work flow changes and how staff will need to adapt.
• The provider is unwilling to change workflow to adapt to interacting with EMR and patient at the same time.  Successful practices have a laptop or Ipad with them in the room with patient.  This change is huge for mature providers who did not grow up on computers and have run successful practices without them for years.  hint: investigate the use of dragon technology.  While this will not completely alleviate the need for change, it will allow for providers not used to “typing” or having typing skills to keep up the pace of average number of patients while converting.  Even this technology takes time and skill to master.  taking time with dragon before EMR installed will lessen the learning curve.
• Key employees leave practice at a critical time.  It’s a difficult reality that some employees simply do not believe they can make the transition and find other jobs at the same time the office is undergoing tremendous change.  This puts undue pressure on the practice and can result in huge loss of revenue.  hint:  give staff adequate time to adjust to the idea of a EMR……allow them to see other practices using effectively.

The reality is single provider practices are under the most pressure right now between meaningful use, the Affordable Care Act and the unknown; practices must make carefully informed decisions if they are going to survive.  The time to make those decisions is now.