Executive search firm Korn/Ferry International states that one of the biggest mistakes when execs join a company or implement changes, is that they fail to recognize the existing culture in the corporation or office. For example, a controlling manager enters a company which utilizes a more collaborative system, which leads to struggles and resistance. It is preferable to find ways to adapt into the pre-existing culture of the office, to assist with the staff's acceptance of the shift from paper-based record-keeping to EMR.

Proper planning and the ability to make minor adjustments while en route is a great way to evade the necessity of completely pulling the plug on an EMR project. This often incurs sizable monetary consequence for a particular practice. A great tool to make use of during a transitional phase of significance is the "change management" concept: undergoing change in a pre-planned and systematical way.

Below find ten important factors in change management which are adaptable for EMR system implementation:

* Acknowledge the human aspect

There will be change and this could cause anxiety. Without 'buy-in' from employees, a new system will probably become a failure.

* Begin at the top

It's particularly important for top staff members, including doctors and admin, to get on board. Among the physicians, a 'champion' is required; that is, a doctor who is committed to realize this project through to completion, hopefully someone savvy with technology but not over-optimistic.

* Every layer needs to become involved

Set-up an employee committee which will develop proposals to be delivered to the physicians. These committee members should be the people who will be utilizing the EMR system, such as admin, business office, and assistants.

* Formally present your case

A need for change will be questioned by the status quo. You'll need a written statement of the vision, explained so that the how, who, what and why of the change to EMR is fully described, with proof that the move to a paperless system is a clearly better alternative. Otherwise, people won't use it.

* Ownership

Group leaders have ownership over different elements of the projects. These members have better cred with their subordinates, in comparison to the doctors. These core individuals should be first trained, then taught to train others in the practice.

* Communication

Keep the dialogue channels open, encouraging feedback at every step. Keep a plan with a sequence of actions. Make sure the staff has the necessary information and is involved in the implementation process.

* Assess

Identify the top values, perceptions, beliefs and potential sources of resistance when assessing the cultural landscape. At times people are set in their ways; for example, the physician who is unable to check email, or the assistant who doesn't like to use a computer mouse.

* Explicitly address the culture

People should gradually learn new skills, in small steps. This will enable them to learn more about using computers, including hardware, applications, and more advanced systems such as EPM practice-management software - finally leading up to EMR. Unless you're able to get the more resistant doctors involved, they could pose problems or delays.

* Expect the unexpected

Problems will surely crop up. Events may cause a delay in the 'live' date of conversion onto the updated system. Tthere will be ripple effects which can be better managed with the right flexibility in planning by the committee.

* Be clear in speaking to every individual

What is to be expected from everyone must be clearly understood. Confidence is good, as not to the point of being unrealistic. When problems do arise it is helpful to be able to counter the fears of the staff members.

In cases of EMR systems failing, often it has much to do with improper planning, inadequacies in implementation, or software deficiencies. The changes occurring on the cultural side will show this to be especially true. Planning the integration into a particular practice before doing the actual program install will be time well spent. This will have an ultimate effect on the bottom line.