EHR implementation checklist for your independent practice

For independent healthcare practices, electronic medical record (EHR) systems can optimize workflows, transform data management, and lower costs. Successful EHR implementation can also improve the quality of patient care.

You may be wondering, “What is an EHR?” If you're new to EHRs, it's important to understand the distinction between EHR and EMR (electronic medical records). An EHR system makes patient health records available across multiple healthcare settings, providing a comprehensive, multidisciplinary view of a patient's medical history. While often used interchangeably, EHR differs from EMR, which are digital patient charts accessed within only one organization.

A well-matched EHR can reap many benefits for your practice. However, a system that doesn’t align with your practice’s specific EHR requirements can have the opposite effect — creating hassles and delays for providers and staff, burying crucial clinical information, and potentially compromising regulatory compliance.

Careful EHR evaluation can significantly alleviate such concerns. However, it’s not uncommon for smaller practices, especially those just starting out, to feel overwhelmed by the EHR implementation process. To help, we’ve broken down this complex process into a clear, actionable guide that includes tips and helpful recommendations.

Identifying barriers to EHR implementation is a critical step for independent practices. This process allows them to anticipate challenges and develop effective strategies for overcoming them before implementation begins.

The most common challenges in EHR adoption include:

Fortunately, independent practices have options for addressing potential issues. To overcome EHR implementation barriers, consider the following:

In March 2024, Tebra surveyed 183 healthcare providers exclusively from small independent practices who use EHRs regularly. When asked what the top 3 most important actions they would take to prepare for a new EHR were, they said:

Integrating an EHR system with existing workflows is a multi-step process requiring careful planning and precise execution. This EHR implementation checklist lays out the key steps and considerations.

Successful EHR implementation requires well-defined steps, careful planning, coordination, clear communication across departments, and precise execution at each stage.

Key steps include:

An EHR implementation sample project plan is essential for organizing and guiding the process. This sample plan includes detailed checklists, such as the following:

Staff training checklist: Ensures all staff members receive adequate training tailored to their roles. The top 5 steps are:

Launch checklist: Confirms all functions are tested and operating correctly before the go-live date. The top 5 steps are: 

Data importing checklist: Supports a smooth transfer of existing patient records into the new system. The top 5 steps are:

According to Tebra's 2024 EHR study, 28% of independent practice providers say that managing downtime is one of the most significant challenges they face when using their current EHR. Downtime can be disastrous when it means you can't access a patient's record when needed. You may have to reschedule patients, and lead to wasted time overall and lost revenue.

Downtime during EHR implementation is inevitable, but careful planning can minimize the impact on your practice. Keep these planning recommendations in mind:

Monitoring and evaluating the new EHR is vital to ensure it operates correctly and meets practice needs. It’s also a way to identify any issues. After EHR implementation, consider the following recommendations:

Success stories highlight effective implementation strategies. Here is one from Fabius Santos, CEO at Optimal Psychiatry and Wellness and board-certified psychiatric mental health nurse practitioner, about how a one-stop solution led to valuable time savings.

In a recent Tebra webinar, Santos discussed his successful EHR implementation and offered advice for other practices: "As an independent practice owner, I can tell you that the EHR does help us providers optimize workflows from clinical charting to patient documentation to specialist referrals. And it saves time, valuable time, that we use on manual tasks or paper charting,” Santos says. This is critical for smaller practices. “You are a solo provider; you don't have a staff or a team to help you. And this helps avoid burnout."

Santos encourages practices to define their requirements at the beginning and exercise due diligence. “This is a big decision … Writing it all down ahead of time will really help you ensure compliance with all the relevant regulation standards. There's different state regulations, and obviously understanding the associated costs."

Team communication is also a high priority. Santos says that getting colleagues on the same page can address resistance to change: "I think these decisions are never easy to make. And I think if there's a big gap between how I see things and maybe how they see things, maybe that would provide a good opportunity to discuss why that is. And hopefully we can make people more comfortable with the change."

Learning a new EHR isn’t easy, says Santos. “I think patient care is already enough, but just learning EHR is difficult, and it takes a commitment from everyone involved. You have to be ready to do work on your part if you want to get results."

For Santos, switching to a one-stop, customizable EHR solution was a game changer. “We were able to customize everything the way that I wanted to and hopefully work on improving our workloads and our processes. Today, luckily we're doing a lot better and everything's running smoothly.”

To hear the full story of how Fabius Santos successfully replaced his practice’s EHR, watch the webinar recording here.

An EHR case study by Health IT highlights the importance of robust vendor support and proactive team communication. It outlines the challenges a hospital pediatrics unit encountered when switching from paper records to EHR. Adhering to MU standards was a high priority for the organization.

Staff found the reporting functionality confusing and difficult to use, among other concerns. In response, the vendor worked with the implementation team to customize the system to specific staff needs without compromising regulatory compliance measures.

Clinical staff expressed anxiety about whether they could capture all patient information required for MU within digital records. To address this specific issue, the organization worked to promote data capture as a team effort, emphasizing that each clinical and support staff member has a critical role.

Within the first year of EHR implementation, all of the organizations' providers met stage 1 MU.

The EHR case study reports numerous benefits within the first year of EHR adoption, such as:

Additionally, all of the organizations' providers met Stage 1 MU within the first year.

Inadequate planning and evaluation are primary contributors to EHR implementation failure. This not only impacts patient care and business operations, but it can also negatively affect the health of EHR users. A 2021 study found that insufficient training and poorly functioning EHR resulted in higher stress levels and lower well-being in registered nurses who had experienced EHR implementation within the last 6 months.

Fortunately, examining patterns around EHR adoption issues can provide valuable lessons.

A literature review commissioned by the ONC emphasizes that “the planning stage of EHR implementation is critical to whether or not implementation will ultimately be successful.”

Examples of specific issues identified by the study as factors in failed EHR adoption:

Planning issues:

Selection issues affected system function, negatively impacting:

Recommendations from the literature and review authors include:

The primary takeaway from these experiences? Don't underestimate the complexity of integrating a new system with existing workflows, or skip critical steps required for success.

Tebra’s all-in-one, ONC-certified practice management software empowers independent practices with highly customizable features and ease-of-use across functionalities. Our platform puts everything you need to run your practice at your fingertips, so you can spend more time on what matters most.

If you’re considering EHR or switching EHR systems, Tebra provides seamless integrations, features that streamline scheduling, charting, coding, and billing, and robust training and support. Take a product tour (no credit card required) or schedule a demo to see our solution in action.