Overall the findings from the meeting mirror some of the findings we have achieved on site visits to health center controlled networks for another part of the current project with training, implementation and converting to new billing processes being the principal challenges and areas of concern in the initial stages of an EHR implementation. DCPCA’s ability to provide more detailed cost information as it relates to their implementation allows us to demonstrate the importance of what are often called soft costs (non-hardware or software costs) in relation to the overall cost of implementation.
The DCPCA experience also demonstrates some of the challenges faced by primary care associations with very little prior involvement in IT to ramp up staff and work with members to create a successful implementation. One ongoing theme throughout the meeting was that having been through systems implementation with DCPCA and other providers, there is a much greater appreciation of each others “day to day lives” and a sense that over time this will lead to better coordination across the safety net in DC and more success with cross provider initiatives.
Another theme that ran across the meeting was a general sense of optimism that the eCW implementation, as supported by DCPCA, would lead to improvements over time. Most tangible improvements related to practice management functionality and billing in particular with providers that had previously not billed at all or comprehensively finding benefits from being able to track services and charges. As it relates to EHRs, even the discussants that reported having the greatest difficulty with implementation expressed the sense that EHRs are an essential means for doing their work at this time, did not see going back to paper as an option and felt that there would be tangible benefits to the new environment that would manifest over time.