The world of electronic medical records can be mysterious and overwhelming. There are client-based servers vs Web-based servers and speech recognition software vs templates. The secret to seeing through the fog is to work with a vendor-neutral consultant who will help you identify your workflow changes, technology needs, and EMR goals.

TMF Health Quality Institute offers professional consulting services at no cost for small- and medium-sized primary care practices through an initiative called Doctor’s Office Quality—Information Technology (DOQ-IT). DOQ-IT is a national initiative led by the Centers for Medicare & Medicaid Services in response to President Bush’s call in 2004 for an EMR for every patient within the next 10 years.

“DOQ-IT is for physicians who want to implement an EMR and don’t know where to begin, or for those who have implemented one but are not using it to its full potential. We can analyze what’s best for your practice and help make decisions about equipment and software,” according to Abe Delgado, MD, TMF medical director.

DOQ-IT participants receive assistance in identifying:

• The EMR system that best meets their needs (TMF is not a vendor of EMR products, nor does it endorse any software provider.)

• Office design and technology modifications that should be put into place to successfully implement an EMR system

• Recommended workflow changes to ensure EMR efficiency and ease in adoption

“The secret to a successful EMR implementation isn’t the product itself, it’s how you use the product,” said Clifford Fullerton, MD, of Garland, a clinical advocate for TMF. “The Olympic runner isn’t good because he has the best shoes. He’s a good runner because he knows how to make the most of those shoes.”

Practices in which the staff understands the office process will have a clear picture of what needs to be changed. DOQ-IT consultants assess the processes, such as telephone demand logs, staff and patient satisfaction surveys, and workflow mapping. “By examining what’s happening day-by-day, minute-by-minute in your office, practices have the full picture to help select an EMR that complements their operation,” Dr Fullerton says.

Dr Fullerton says that although a vendor may begin this type of assessment before the system is purchased, vendor support usually drops off two or three months after implementation. “You spend a lot of time at the beginning just learning how to interface with the EMR and enter a patient encounter,” he says. “Once you’ve got that part down, the vendor is out of the equation. But you still have not fully implemented the process changes needed to improve the quality of care that the EMR facilitates.”

DOQ-IT assistance offers practices support before and after implementation. “Our consultants will help you build on the product you purchased for years to come,” according to Dr Delgado. “We want you to get the most out of your EMR and feel like your practice is moving forward.”

Practices that seek this level of assessment through DOQ-IT also are well positioned for what is on the horizon—pay-for-performance. “It is widely expected that physicians who provide better care will be paid more in the future, either through CMS or other insurers,” says Dr Fullerton. “By learning how to use the full functionality of the EMR through assistance with DOQ-IT, practices will be prepared for pay-for-performance.”

Primary care physicians must apply to be considered for the DOQ-IT initiative, which formally began in August. More information is available at www.doqit-tx.org or by calling Tara Frease, project manager—physician office quality improvement, at 1-800-725-9216.