Here’s a little anecdote which deserves some attention. In the kind of nightmare scenario that keeps C-suite folks up at night, a hospital in Indiana saw wait times in its emergency department soar to double what they were once it installed an EMR.
Columbus Regional Hospital, which sits about an hour south of Indianapolis, installed a new EMR in June. Prior to installing the system, average ED wait times hovered at about two hours and 25 minutes for fast tracked, less-severely-ill patients, while acute-care patients waited an average of two hours and 32 minutes.
But things got ugly quickly once the EMR went live, reports iHealthBeat. During the first week of the EMR transition, fast-track patients waited four hours and 41 minutes for ED care, while acute care patients waited four hours and 13 minutes. This happened despite the fact that the hospital had brought in extra nurses to ease ED overcrowding.
Over the past two months, wait times have come down to similar, but slightly higher, levels than they were at before the EMR was put into place.
I suspect the problem occurred because the hospital simply got caught flat-footed. Adding extra nurses is a good first step, but unless the news sources I’ve accessed have failed me, the institution didn’t do much to anticipate where the snags would be.
So what exactly happened here? Of course we don’t know, but it’s easy to make a few guesses.
One possibility, of course, is that the EMR was installed poorly or unready, though I’d guess this was less likely given the pressure on IT departments to get it right.
Did the hospital do enough to train doctors and nurses on the system before the pressure was on? It seems fairly likely that it did not.
The real cause of Columbus Regional’s problems, however, is probably that the hospital bought a cruddy EMR and superimposed it on a not-too-efficient ED operation. (Those original wait times sound pretty heinous — acute patients waiting more than two hours? — much less the post-EMR figures).
It seems to me that this hospital’s ED processes must have had one foot on a banana peel already when the EMR was launched. Sadly, even the best EMRs can’t fix problems they aren’t designed to address.