We are currently in the process of developing our EMR and it will have 'required field' components. Even though I cannot answer your first question, I can hopefully say that it will lead the organization to a more improved compliance.

We are also currently implementing the EMR system. It takes a long time for the transfer from paper to electronics to complete but when it is fully implemented, it will be in compliance with all regulating bodies requirements. In addition, there are required fields for improved compliance but it is not automatically linked to those bodies.

Our goal by the end of the year is to be 100% EMR. This has been a several year long strategic plan goal. We utilize a EMR system which has like any other EMR system advantages and disadvantages. Implementation has not been without problems. Often implementing one system or upgrading has caused malfunction in another. The beauty about this system is our ability to build it our selves with pop up screen reminders and " required fields." This is great to facilitate Joint Commission complaince but glitches in the system may automatically lose these screens and then our documentation so carefully built to meet Joint Commission standards, CMS core measures and quality initiatives are totally lost with us at the mercy of the company to help with new integration and repairs. Our IT department does a fantastic job but they have had to work 24/ 7 at times to faciliate physicians education and compliance. The system takes more time to utilize to document than paper system. The ED CPOE has been our greatest battle to gain support as it required physician participation to learn and we had many physicians that never turned a computer on much less, complete all their documentation on it. I do not believe there is one EMR system that actually decreases documentation time and staff are well aware of this. In our recent employee satisfaction surveys the cumbersome EMR tool was one of their top 3 dis-satisfiers. We are reviewing other potential vendors for EMR yet with the expense and years of utilization so far with our current system, switching to another vendor will be difficult. We implemented scanning medications with bar coding and patient barcoding. We have seen a decrease in our medication errors. There are work arounds that administration must be prepared to find and scanning every nurses % of compliance became necessary to ensure the process was completed.

I don't know what is like to work in an organization without electronic medical records. The challenge of getting the physicians to sign and date verbal/telephone orders within 48 hours will continue to be an issue. We are trying various ways to improve compliance but there is much push back.

I have implemented an EMR and hesitated with mandatory fields as they do not drive compliance just work arounds and will stop the movement if unable to work around it somehow. It still comes down to good and complete documentation. The task list reminders are the best means of gaining compliance and reporting is much easier.