Last week, my colleague Katherine Rourke wrote a post on how one hospital ended up junking its $50 million EMR after it turned out doctors wouldn’t use it. You seemed to be quite interested; the post drew more traffic than virtually any piece we’ve posted since we launched this blog.
I would have loved to follow up with more case studies on hospital EMR failures, but I simply couldn’t find any, other than hints on health IT news and gossip site HIStalk.com. From Web searches alone, you’d think all EMRs rollouts were joyful walks in the park.
I guess I shouldn’t be surprised. After all, nobody wants to publicize when they’ve blown their budget on technology that doesn’t cut it. And vendors obviously don’t want to publicize this kind of result, so they’re unlikely to spill the beans. But it’s a real shame. After all, few industries improve their game if they don’t share worst practices along with the best.
The closest I came to insights on EMR failure was a postmortem, from 2010, on why the Department of Defense’s $2 billion, 13-year EMR implementation didn’t work. According to to the GAO, the project finally faltered because of poor planning, poor execution and a failure by leaders to grasp just how complex their program was.
One might also cite the extremely painful and drawn-out process Kaiser Permanente went through in rolling out its Epic EMR, which was famously slammed in public, to 100,000+ employees, by a frustrated low-level employee. While not a “failure” as such — in truth, these days Kaiser seems to be making great use of its investment — the project was rumored to have cost the company a tidy $4 billion or so, piled on top of hundreds of millions it had already spent on a failed home-grown system.
Honestly, everyone who reads this probably has a pretty good idea of why EMR projects fail. Generally speaking, it seems to boil down to a few key mistakes such as:
* The health system or hospital didn’t get realistic input from doctors, or disregarded such input, and so failed to realize that their clinicians would be miserable
* The institution couldn’t mount the system quickly or efficiently enough to satisfy users, causing problems that demanded a new approach
* IT leaders didn’t realize how big cost overruns would be for support, interfaces or other long-term development needs
But generalities only go so far. In truth, I’d argue that most hospital IT leaders get far, far too little feedback on why specific EMR projects failed. And so they miss red flags that might have saved their organization a ton of money and grief. Like I said, it’s a shame.