I work for a health and human service agency and we've gone through 2 EHR implementations. Using the old cliche "the devil is in the details" is very appropriate when approaching your EHR selection and implementation. You need to have a clear understanding of what it is you do and how you do it. Do not make assumptions as to your workflow processes as this could be deterimental to your selection process and subsequent implementation. Get input early from key stakeholders that will be accessing the system (Billing staff,clinicians, field based staff, admitting staff, QA, IT,and of course your execs). Ask for customer references and call, or schedule a site visit. Insist that the vendor provide you with the names of customers that my not be on their "preferred customer" list. You can learn a lot from customers that have struggled with their implementations. Have the vendor perform scripted demonstrations. You don't want to see the marketing show and tell features, you need to know how the software will work within in your environment. EHR implementations are time consuming and costly. You need to arm yourself with as much information as possible before you sign the contract.

One of the less advertised aspects of the ARRA stimulus funding to promote the adoption of EHRs is the Federally subsidized Regional Extension Center (REC) program which established 62 consulting centers across the nation to provide very low cost (in some cases, free) expertise to help providers get through the arduous task of adopting an EHR.

RECs assist practices to achieve meaningful use no matter where the practice currently is along the path. They can help with everything from initial practice assessment, workflow analysis, vendor evaluation and contract review. But even if you've already committed to an EHR, you can then use ALL your funded consulting hours to help with training, meaningful use gap analysis (i.e., how far away are you from achieving and what do you need to do to get there), guidance regarding privacy and security requirements, registration with CMS for the appropriate available Medicare or Medicaid incentives and finally, attesting to meaningful use both now and in the coming years. In Texas, for example, it costs just $300 per provider to access 20 hours of CME coursework and anywhere from 30 to 50 hours of on-site consulting services.

This article outlines the 7 deadly sins of EHR implementation. Maybe the 8th should be not availing yourself of help when it's there for the asking.