| Recently I met with colleagues; some practicing | | | | commonly available for sale at retail. It's important |
| physicians in both Family Practice and Neurology. | | | | to gather and maintain service agreements, |
| Both hadn't yet gone over to EMR. There are | | | | including back-up servers and switches. |
| two primary reasons that they haven't gone | | | | Problems with Change Management - Anyone |
| ahead with EMR: | | | | expert in dealing with proper implementation of IT |
| Where should I begin? We often wonder this, and | | | | projects will tell you. No matter which industry or |
| especially so if we have friends or colleagues who | | | | area of business we're talking, everyone mentions |
| have tried but were unsuccessful at implementing | | | | the human factor as the top cause of failure. EMR |
| EMR. Most of the time these are strong efforts | | | | isn't any different. Plenty of newer physicians |
| conducted in earnest, though at others the firms | | | | have grown up on technology, even training at |
| were just going through the motions. Some | | | | institutions which already use an electronic |
| teams quit as time wore on, and others were | | | | record-keeping system. These people don't miss a |
| knocked out of commission. Some lost time and | | | | beat. Same is true for young people on staff who |
| money on their attempts, then decided they | | | | are accustomed to texting and social networking. |
| were done. | | | | However, some of the more venerable doctors |
| About thirty to fifty percent of EMR projects fail. | | | | have more of an adjustment to make. Maybe |
| At first, this high figure surprised me. Then, when | | | | they've only started using the Internet recently, |
| asking around a bit, I'd talk to somebody who'd | | | | and suffer from a technology inferiority complex. |
| had a bad time, or knows someone who has | | | | Workflow processes are also involved in change |
| experienced failure. Especially when trying to | | | | management. Inefficiencies in patient care can |
| calculate the failure rate, it becomes difficult to | | | | only be exacerbated on an electronic platform. |
| discern between a 'true' failure and an | | | | The go-live date is not the date to discover that |
| 'abandonment.' The latter is the case when the | | | | the new EMR system doesn't live up to the way |
| staff simply stop using the system or trying to | | | | they've always done it before. Proper technical |
| implement it. Of course, whether it is called a true | | | | planning can also help ensure there is proper 'fit' |
| failure or an abandoned project, the result is | | | | between the practice needs and the EMR solution. |
| similar in terms of lost time, money, heartache, | | | | This can mitigate such failure factors as unrealistic |
| and a practice which then still needs to fall back | | | | expectations about the time it will take to get the |
| into reverting to paper medical records. | | | | EMR working properly, loss of productivity in the |
| Here are some primary causes of EMR | | | | clinic, and inadequate customization. All of these |
| implementation failure: | | | | can lead to abandonment of the software |
| Not Having a Clear Purpose - Some EMR projects | | | | system and in a perpetual search for the 'perfect' |
| are in trouble from the start. If the future goals | | | | EMR solution which is never realized. |
| for the system aren't described and understood, | | | | The resistance to new technology appears in |
| the chances of forming a good plan drop. Further, | | | | several ways which include withdrawal and refusal |
| dreamy expectations with unclear markers | | | | to participate. Providing the necessary training for |
| further reduces the chances of survival. When | | | | these staff members is key for preventing a |
| practices don't keep a clear watch on the | | | | learning curve from being too steep to be |
| situation, or fail to get quality help, could have | | | | accomplished before the launch date. Some older |
| avoided the problem of having no purpose. What | | | | workers could require a lot of training. The training |
| is it that your practice wants the EMR system to | | | | plan needs to identify those who are trailing |
| do? If unsure about what you want, ultimately, | | | | behind or require more help. For the simulation |
| you won't understand what the EMR system plan | | | | day, you will need the ready skills and group |
| needs to thrive. | | | | vested interest in success in order to successfully |
| Poor Plan and Implementation - This covers the | | | | implement EMR. |
| whole gamut, between software and hardware | | | | Lack of Leadership or Commitment - Do you |
| issues. This category covers the entire gamut, | | | | have a doctor to champion the project at your |
| from design and set-up, hardware and software | | | | office? Groups of physicians must reach |
| issues, to roll-out into implementation. There | | | | agreement and keep things moving along at a |
| should be either a dedicated IT person on-board | | | | healthy pace; otherwise, even a small glitch and |
| with the project, or an outsourced consulting firm | | | | send things down the wrong path. The champion |
| to assist with the plan and implementation. This | | | | doesn't have to be the most enthusiastic, but |
| assistance could include training planning, product | | | | they must have expressed buy-in and a |
| design, and the stages of implementation. This | | | | commitment to the project. When a practice's |
| category covers the entire gamut, from design | | | | staff start to feel the dissent coming from |
| and set-up, hardware and software issues, to | | | | above, it could spread bad juju throughout the |
| roll-out into implementation. Some work | | | | community. You'll want to avoid a situation when |
| breakdown structure must be in place as well, to | | | | the workplace becomes a place of camps divided. |
| keep things running on track. A live simulation day | | | | If the project fails, the whole team fails - not the |
| is another important threshold to pass | | | | initial champion of the cause. A mutinous tone |
| successfully. Together, these are the components | | | | could rise up somewhere in the group, either one |
| that allow for success, particularly in crisis | | | | doctor or another staff member; either way, it is |
| situations. You should plan to experience a few | | | | someone who will actively work against the |
| along the way. | | | | project. The champion needs to find out and |
| The IT advisor is able to help with hardware | | | | re-direct the circumstances in this case, stopping it |
| purchases for the network, meanwhile helping to | | | | there before the influences travel too deep into |
| keep the overall costs acceptable. I don't | | | | the organization. Communication lines should be |
| recommend trying to squeak by with the | | | | functioning well, with meetings scheduled before, |
| cheapest technology, either. Trying too hard to | | | | during, and after the date of EMR launch. The |
| control infrastructure costs can backfire in the | | | | system must change to address a problem |
| end. If your medical practice is smaller, it may not | | | | before users start to become de-motivated and |
| be advisable to purchase consumer equipment | | | | give up hope. |