Eligible physicians are dropping out of the HITECH incentive program. Why? Often, it’s because a practice implements an EHR and then tries to mimic all their old paper processes and workflows.

That can get them through the vendor’s initial implementation, but it is not sustainable for the long term.

Workflows and operational processes must be modified to optimize the new tool. Technology changes what is feasible, and to adapt, we need to change what we do every day.

To get the most out of your EHR, adopt these seven Golden Rules:

1. Include the nursing staff! The EHR is not all about the physician! Physicians are the owners or the leaders or the key decision makers but they are not the exclusive users of the EHR. In fact, nurses account for about 75% of the use of the chart, and a successful EHR implementation focuses on how the nurse can assist the physician in the integration of the EHR into clinical workflow. Too often, an EHR committee is created in a medical practice with no nursing representative. Bring in the nurses!

2. Schedule MORE training specific to process, not just how to fill in a screen. Schedule time outside of office hours for you and your staff to get on the EHR and actually walk through the tasks you perform each day with an eye to how to minimize the number of touches to accomplish each task. That means it will cost you overtime, or lost productivity if you close office hours, so budget accordingly. The additional training costs will help your investment in the EHR pay off in the end.

3. Anticipate the stress and effort required over several months. The adoption of technology is an iterative process. The EHRs are full of features and functions that will bring efficiency to your operations but it is impossible to take advantage of it all in the first two months of your go-live. Typically, groups will be in the learning and adoption transition for about a year. Be prepared for the long haul!

4. Round on users (providers and clinical support staff). Round on everyone in the practice just as you’d round on your patients in the hospital. Visit each user 30 days after your go-live and again after 6 months — even if it’s only for a few minutes. Observe how they’re using the system and identify short-cuts or tips you can offer on how they can use the EHR more effectively. Learning elbow-to-elbow is quick and nonthreatening. Make rounding a regular activity — every user should be observed at least twice a year.

5. Personalize and recognize the differences among physicians. Don’t try to force all physicians to do the same thing. Incorporating technology into personal use is not one-size-fits-all. People approach even the simple technologies like email and word processing differently. The EHR applications provide several ways to accomplish the same task (which adds to the training complexity) so be sure to offer providers the variety to choose what will fit their practice style the best.

6. Get your EHR-integrated patient portal up and running with interactive services for your patients. Invite your patients to sign on with the portal at the teachable moment — in the exam room. Providing test results and allowing patients to request appointments and prescription refills online will save your staff time and increase patient satisfaction.

7. Don’t become a drop-out. Stick with it. You didn’t learn to ride a bike in a day either.

Follow these golden rules to optimize your EHR implementation, earn all the potential incentives, and increase your operating efficiency and your practice profitability.

Rosemarie Nelson is principal, MGMA Health Care Consulting Group and blogs at Practice Pointers.