Implementation of an EHR in a Small Family Practice

Ericka Simmons
Abstract— This research paper was conducted to demonstrate that it is useful, positive and
negative with problems that are related to the implementation of the electronic system
Health Record in a small private family practice group. The following items are part of the
future use of research in this paper: The implementation of the project, government
security, and system recommendations.

I. INTRODUCTION
A small family practice with only three doctors in a HIT budget of 60,000 annually with
150,000 for upfront expenditures, can have many applications and challenges with the
implementation of an electronic health record system into their private family medical practice
start.
A. EHR Functionalities
The most important functionalities of the EHR that need to be implemented into practice
are charting, scheduling, and billing. “Chart accuracy is both a measure and a means of ensuring
the quality of the care that patients receive.” (1) The accuracy of the patient chart information
may facilitate and enhance communication between healthcare professionals responsible for
providing care to patients, both in hospitals as well as upon discharge into the community.
Scheduling saves time and effort and is paperless and seamless. Billing can eliminate lost paper
bills and increase the rate at which claims are accepted on their initial delivery. It can enhance
the paper bills which can be electronically generated and then billed to the insurance companies
and reduction in the rejection rates of insurance claims allowing them to fill out your claims and
track them, as well as determine whether a claim has been denied, correct, and resubmit it
B. Integration of Practice Management System
It is possible for any existing PMS to be integrated with the EHR. The possibility to
monitor and analyze performance in each area of the practice may be made available for
administrators and medical staff. Practices which have a complicated organizational structure or
who operate from several locations can also offer higher value by means of an Integrated and
Comprehensive Practice Management System. In this respect, the full integration of a practice
management solution can allow an efficient coordination of activities relating to departments and
locations in terms of staff, billing, or inventory control. It is possible that a practice will gain an
appreciation of their weaknesses and strengths, enabling it to make more intelligent decisions in
relation to how they can be improved and exploited.
II. ADVANTAGES IN USING THE EHR
 Ensuring accuracy, updated and complete patient information at point of care. Facilitating
better coordination and efficient care through quick access to patient records. Secure sharing of
electronic data between patients and other healthcare professionals. Helping health professionals
to diagnose patients more accurately, reduce medical errors and provide better care.
III.CHALLENGES IN IMPLEMENTING THE EHR
Resistance and opposition to changing from paper-based systems to electronic systems
may create some problems. Identified challenges include financial burdens, personnel resources,
patient safety threats from limited access to legacy records, data integrity during migration,
cybersecurity, and semantic interoperability. (2) Some other issues contributing to the stats
include the lack of reimplementation activities and the lack of organizational readiness.
Project Planning and Management
I would build a team of healthcare experts who are familiar with the type of system that is
about to be implemented. First, I would develop a roadmap for the implementation of the EHR.
Recruit the EHR implementation committee and then forecast the EHR implementation costs as
well as define a budget. Lastly, schedule the EHR implementation and make sure that patient and
practice data have been transferred correctly.
IV.TECHNOLOGY CONSIDERATIONS
This should be discussed with the healthcare team well before the type of system is even
implemented. According to the HIPPA Journal, “the Security Rule lists a series of specifications
for technology to comply with HIPAA. These include:
• All Protected Health Information (PHI) must be encrypted at rest and in transit.
• Each medical professional authorized to access and communicate PHI must have a
“Unique User Identifier” so that their use of PHI can be monitored.
• The use of any technology to comply with HIPAA must have an automatic log-off to
prevent unauthorized access to PHI when a mobile device is left unattended (this also
applies to desktop computers). (3)
A. Strategies for Disaster Recovery
The issue of cloud computing should be considered, and options in storage media should
be assessed. As a matter of contingency plans, HIPAA requires that organizations consider how
to react in the event of a natural disaster or emergency. If an organization experiences a serious
or other incident, strategies should be put in place for recovering and maintaining access to ePHI.
The type of backup you need, e.g., a CD or cloud computing server, should be considered by the
entity. A power outage could also be a top concern for organizations, and they should make their
own decision whether to require standby generators, such as it is.
B. Cloud Computing Considerations
Both the on-premises and cloud computing environments can be supported by cloud
backup and disaster recovery solutions. For example, if you want to retain your production
environment in a data center of your own, you could choose to keep just the backup or
replication files on the cloud. You still benefit from the advantages of scalability and geographic
distance without having to move your production environment with this hybrid approach. It
would be hard to develop a plan which relied entirely upon an on-site environment for disaster
recovery. Your whole data center, with both basic and secondary systems, is at risk of suffering
from an emergency or power outage. Consequently, many disaster recovery strategies rely on an
alternate location which is several kilometers from the primary data center.
V. FINAL RECOMMENDATION BASED UPON DATA
The type of EHR system that should be used would depend on many factors, including
cost, training, and whatever the practice's needs are. Upon looking at various providers for this
small family practice, I researched the company called Practice Fusion. On their website, I
noticed that their pricing was ideal for this small practice in that it was $149 per provider per
month which would be billed monthly and required an annual commitment from the provider.
“Practice Fusion is the #1 cloud-based electronic health record (EHR) platform for doctors and
patients in the U.S., with a mission of connecting doctors, patients, and data to drive better health
and save lives. By facilitating over five million patient visits a month with more than 600
connected partners, Practice Fusion helps coordinate care within the largest healthcare ecosystem
in the U.S. As the most widely used cloud based ambulatory EHR, Practice Fusion is helping to
reshape the future of healthcare.” (4)
VI. CONCLUSION
In conclusion, the implementation of Electronic Health Record (EHR) systems is meant
to assist providers’ evidence-based decision-making (5) and streamline providers’ workflow via
efficient coordination for patient care. (6) What I have come to learn over the course of this class
is that digital technologies have transformed our world, transformed how we live and what we
communicate with the advent of smartphones, tablet computers, or internet-enabled devices.
Medicine's an enterprise with information at its disposal. Information is available with electronic
health records whenever and wherever it is needed.

References
1. Physician Documentation Expert Panel. A guide to better physician documentation. Toronto:
Ontario Ministry of Healthand Long-Term Care; 2006.
2.Huang C, Koppel R, McGreevey JD 3rd, Craven CK, Schreiber R. Transitions from One
Electronic Health Record to Another: Challenges, Pitfalls, and Recommendations. Appl Clin
Inform. 2020 Oct;11(5):742-754. doi: 10.1055/s-0040-1718535. Epub 2020 Nov 11. PMID:
33176389; PMCID: PMC7657707.
3.The Use of Technology and HIPAA Compliance (hipaajournal.com)
4.Purvis, R. Senior Director of Marketing (2023) Practice Fusion Practicefusion.com
5. Kruse CS, Mileski M, Vijaykumar AG, Viswanathan SV, Suskandla U, Chidambaram Y.
Impact of electronic health records on long-term care facilities: systematic review. JMIR Med
Inform. 2017;5:e35.
6. Wani D, Malhotra M. Does the meaningful use of electronic health records improve patient
outcomes? J Oper Manag. 2018;60:1-18.