One of the things that EHR salespeople and EHR vendor websites like to proclaim is that their EHR can be implemented with no change. They use adjectives like “easy” and “simple” to describe their EHR implementations. Certainly EHR salespeople are trained to say things like “will adapt to any workflow” and “our system is so configurable you can change it however you like.”
Certainly this type of message rings well with doctors who are afraid of the changes that EHR will bring. Let me assure everyone who’s reading this that EHR requires change. This is true of every EHR vendor, for every specialty, and every size organization. Change and EHR go hand in hand. What we have to get over is thinking that change is bad. Change can often be good, if it’s done right.
HP recently put out a detailed whitepaper discussing “Four EHR Change-Management Mistakes (And How To Avoid Them)“. It’s one of the deepest looks at managing the change that comes with EHR that I’ve seen.
For those who don’t want to read the whole whitepaper, here are the four EHR change management mistakes:
1. Mismatched IT
2. Misplaced Resources
3. Missed Accountability
4. Mismanaged Logistics
The whitepaper also talks about the evolutionary role of IT in today’s medical practice. First, IT provides basic functionality. Next, IT adds some value. Finally, IT delivers significant benefit. I’ve seen this evolution first hand in many organizations. Each step of the process requires managing changes that lead to the eventual benefits. However, far too many people get stuck in the basic functionality and never make it to the significant benefits.
If I were to take one of the mistakes above to highlight why many miss out on significant benefits it would be Missed Accountability. At the core of this idea is having effective leadership. I’ve never seen an organization go through the EHR change effectively without strong leadership.
What do you or your organization do to manage the change required by EHR?
I have heard essentially the same issues since the late 1980’s.
Some things never change.
But, and more importantly, these sort of articles call into question the very essence of HITECH/ARRA and the EMR initiative — ROI.
Was this expected to be, and will it turn out to be a big waste of money?
Can the Fed govt. successfully perturb a marketplace that prior to the interference was relatively unsuccessful in winning and retaining end-users?
If the money had been spent on basic bio-medical cell research, or even targeted genomics for cancer, diabetes, and Alzheimer, would the ROI be much greater not just in economic terms but population quality of life?
Change is the one constant.
I think EHR is a platform for amazing good and is needed. We could discuss forever if the HITECH money was spent well, but it’s kind of water under a bridge at this point. It increased adoption and now we need to keep building the value that comes on top of the EHR data.
To answer your question, “What does our organization do manage change?” A business and technology assessment. Kanick And Company performs this at the first get together because we want to understand the practice’s business today and where it wants to head in the future as well as see the technology in place and what is missing to allow for an easier transition. I ask, how many other EMR vendors take that much time to understand the company before implementing their systems? Apparently not many.
@Deanna, we do this at BuildYourEMR. We would never state no change, but we do strive to recreate the current experience electronically with forms, workflows, and vernacular that matches the practices everyone uses today in order to minimize the change. After using our system for a while, the physicians and staff start to deploy their own changes the improve performance.
@John is right on target. There are forces in healthcare that are highly disruptive. The good news is some of this disruption has already forced some proprietary vendors to innovate.
It can be argued that any program worked or did not. In the end, decisions were made and we are all right here. The best bet is to stop using sunk costs as the basis for decisions and plan next year and those beyond based on where you want to be, not what you wish you had.
Mike