Smooth Transitions: Integrating Into a Multispecialty EHR

Specialists who have worked with electronic health records (EHRs) are well aware that most EHRs are designed with PCPs in mind, with minimal regard for the intricacies of subspecialty work flows.  As more and more specialists align with hospitals and health systems, integrating with multispecialty EHR systems and leveraging this technology to improve care quality and performance is critical.  Whether you’re already part of a multispecialty group, considering joining one, or evaluating a new EHR solution, you need to make sure the EHR meets your needs.


In this era of alignment, specialists need to have a voice in discussions concerning EHR solutions and optimization.  Regardless of the EHR system, there are specific approaches you can take to effectively integrate with a multispecialty solution.

  • Collaborate with leadership and make your EHR needs known.  Help leadership understand what’s missing from the current EHR setup.  If your requirements are known, many vendors will work with large groups to provide improved solutions, or at least temporary workarounds, to match your ideal work flow.
  • Customize templates and develop order sets.  An out-of-the-box EHR may not fit the work flows of your practice.  However, you can often modify the system to meet your needs by working with your IT department or the EHR vendor to customize templates, lists of favorite selections, and work flow processes.
  • Institute device integration.  Integrating your external devices (e.g., EKG) with the EHR can greatly reduce the manual entry of information, enhance accuracy, and increase timeliness of data.  Working with leadership to prioritize integration requirements may help to ensure that IT staff are focused on the most critical opportunities.


If you’re thinking about joining a medical group, there are considerations to address to ensure your EHR needs will be met.

  • Demand a hands-on demo.  Know the capabilities and limitations of your technology up front.  Screenshots or controlled demos of a cardiology suite, for example, offer only a glimpse into an EHR system.  Hands-on demos, on the other hand, offer the opportunity to ferret out potential problems before it’s too late.
  • Identify “deal breakers.”  Identify the work flow processes and systems required to maintain productivity and patient care outcomes.  Before joining a medical group, a plan should be in place to integrate key capabilities and information into the enterprise’s EHR solution.
  • Provide examples of routine and complex patient types.  Learn how the EHR supports (or doesn’t support) the types of cases that make up most of your day.  If a high level of customization is needed to efficiently meet your practice’s needs, specific requirements should be documented in the implementation plan and tested prior to go-live.
  • Speak to current specialists within the group.  Talk with a general surgeon, orthopedist, or other specialist who may have faced challenges in working within the EHR and can provide valuable insight.


Successfully integrating into a multispecialty medical group is challenging.  Providers need to make their needs known but also be willing to compromise to find a suitable solution or improve an existing EHR system.  However, if you are active throughout all phases of EHR implementation and ongoing adoption, a multispecialty system can become a sustainable solution that provides immense value to you and your patients.

This post is adapted from a column that originally appeared in the August 2014 issue of CardioSource WorldNews, a publication of the American College of Cardiology.

This entry was posted in Cardiology, Clinical Integration, EHR/EMR, Integration, Performance Improvement and tagged , , , by Nate McCarthy. Bookmark the permalink.

About Nate McCarthy

Nathan’s vision of the power and potential of a truly connected health network distinguishes his work and his role as a leader of IT engagements and teams. He brings deep knowledge of population health management, telehealth/mobile health, and integrated care delivery, and he is committed to being a catalyst to promote change that enhances patient care and safety through strong linkages between IT and quality. He has led cross-functional teams for improvement projects where the outcomes are measured in saved lives through actions such as reducing adverse drug events and wrong-site surgeries. Nathan approaches each client engagement with a fresh perspective, assessing cultural, clinical, technical, and financial barriers and then crafting unique solutions to IT strategies and department redesign. As an interim manager, he has transformed disparate groups into highly productive and collaborative teams, and as a certified Lean/Six Sigma Yellow Belt, he has trained and served as a Black Belt Champion. He frequently draws upon his background in process improvement and Lean/Six Sigma to solidify the relationship between technology solutions and quality outcomes. In addition, Nathan has extensive experience managing NextGen Healthcare Information Systems, LLC, and eClinicalWorks (eCW) implementations and managing, optimizing, and converting clients to other EHRs. He has a master of health administration degree and a bachelor of science degree in health information management, both from Saint Louis University.

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