Choosing an EHR: Help for Practices Without Full-Time IT Staff

Scott Irwin


March 28, 2011


Electronic health records (EHRs) are not just the concern of the largest, most resource-rich practices. Smaller practices face unique challenges when it comes to finding the right EHR, but strategies and resources do exist to help overcome those obstacles.

Before discussing those strategies, what constitutes a "small" practice should be defined. Various industry groups describe small practices as those with fewer than 2, 5, or even 10 physicians. But when it comes to the EHR and other information technology (IT) issues, the number of physicians in a practice matters less than the practice's IT capability. After all, a 2-doctor practice with a full-time IT resource on staff generally will have different concerns from a 2-doctor practice without any IT help. So, for the purposes of this discussion, a small practice is defined as one that cannot afford dedicated full-time IT services.

Taken in that light, the 3 biggest EHR selection and implementation challenges typically confronting small practices are the amount of training time necessary, the overwhelming nature of the IT commitment, and cost. Admittedly, these issues are listed in reverse priority order. However, each aspect is important to address.

Challenge #1: Training Time

Doctors in small practices seldom have the luxury of being able to simply stop seeing patients for the time it takes to train on a new EHR system. Who will care for patients if a physician sets aside a morning for training? And what will happen to the bottom line if physicians reduce their caseloads?

Although the amount of time it takes to actually implement and maintain an EHR is sometimes an eye-opener for small practices, there are 2 ways to reduce the impact: Look for vendor flexibility and focus your training.

Training doesn't necessarily have to occur in-person between the hours of 8 AM and 5 PM. Small practices are especially well served by vendors flexible enough to work within your schedule, not theirs. Check to see whether a vendor provides after-hours training. Better yet, find out whether a vendor offers e-learning tools that can be completed at each individual physician's convenience.

Training tailored by job function can also help reduce the time commitment required. Many vendors will offer separate training sessions for physicians, nurses, and front-office staff, for example. Session segregation allows trainers to quickly narrow the focus and deliver just the information that each group needs to know.


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