How Can Rural Physicians Get Electronic Medical Records?

Although the 2009 economic stimulus package and both the House and Senate versions of health reform include funding for information technology such as electronic medical records (EMR), many small physician practices--especially those in rural areas--are wondering how to make the leap, according to a survey administered by the American Academy of Family Physicians. Understanding how rural physicians can get EMRs involves getting a clearer picture of how to develop a selection process, finding funding and training staff and doctors alike on how to use it.

Selection Process

• The primary step in a strategy for rural physicians to get electronic medical records is to map a process for matching the physician practice with the right EMR system. There are hundreds of companies that make EMR systems, so there are a lot of options for every type of practice, be it a doctor operating solo to a multi-physician group practice. The American Academy of Family Physicians has published a white paper outlining 12 steps to selecting the right system for your practice (link in Resources). Thinking about work flow issues in your practice, determining what kinds of functions you want an EMR system to provide, writing a request for proposal, deciding what companies you would like to respond to your proposal, and evaluating proposals for cost and functionality are all critical parts of the equation.

Funding

• Many of the physicians interviewed for articles about rural adoption of electronic medical records in newspapers such as "The New York Times" or on radio stations such as National Public Radio mentioned cost as one of the major factors in adoption an electronic medical record system. Determining how you are going to pay for an EMR system is a key part of the strategy. Physicians report investing in the technology themselves or finding outside private funding to pay for the systems; the 2009 American Recovery and Reinvestment Act also made funds available through state governments to promote EMR systems and usage in physician offices.

Training

• Another key part of a strategy to get electronic medical records in a rural physician practice is training. Because EMR systems involve replacing the paper record system in place in a medical practice, all staff--doctors, nurses, nurse practitioners, physician assistants and front-desk staff--will need to learn how to use the new system. Physicians interviewed by "The New York Times" reported closing the office for two days to complete training; according to these doctors, a representative of the EMR system's manufacturer also stayed on site for the first few days of implementation to help the office learn how to use the system.