Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Wednesday, October 17, 2007

Clinician Involvement – Avoid at Your Peril!

I came upon this article from the magazine ADVANCE for Health Information Executives a few days ago.

Importance of Physician Leadership in EHR Selection

Employees need to be actively involved in EHR implementation to ensure smooth integration.

By Gary Kennedy

In the whirlwind daily life of medical practices, electronic health record (EHR) implementation is often met with great skepticism and resistance. But the old mantra of “no budget, no time, no IT resources,” is no longer a good enough excuse for practices hoping to keep up with increasingly sophisticated patients and the federal regulations. In coming years, the EHR will become commonplace, and probably mandated.

The EHR can be as useful to the solo practice, as it will be to the group practice. The problem is two-fold: (1) how to guarantee that your practice selects the right EHR, and, more important, (2) how to leverage it to ensure that doctors make better decisions.

The EHR selection committee


To avoid an aborted or delayed selection process, or a failed implementation, make sure that your practice’s most influential business drivers are on the selection committee -- led by the physician sponsor. Ideally, the executive physician or chief medical officer appoints members to this committee, establishing clear lines of ownership and accountability. Keep your enemies close: Remember partners or key employees who could easily derail the process, invite them to participate, give them committee responsibility and make them your allies.

A physician who is intimately familiar with the software and has oversight where changes and adjustments need to be made can enhance the quality of communications with the vendor. This individual must be willing to put in extra, possibly uncompensated, hours doing research and management tasks. If this individual is not the physician sponsor, all the better. You may be surprised at how different practice stakeholders can collaborate to accelerate return on investment. Identify the goals for the EHR before beginning the search, then evaluate the EHRs by how they meet these goals, and by value added beyond specific goals.

For example, Barry L. Fisher, MD, led the efforts of his employer, IASIS Healthcare LLC, headquartered in Franklin, Tenn., to adopt RemedyMD’s BariEHR in a system-wide effort to achieve Center of Excellence certification for bariatric surgery across its hospital system.

IASIS, a company heavily invested in electronic data collection and retrieval, already had an in-house electronic records system accessible through its intranet and had experienced all the data headaches that came with its implementation.

According to Dr. Fisher, selecting BariEHR was based on RemedyMD’s ability to retrieve, maintain and analyze the data, its flexibility to respond to specific needs at each site, and to utilize shared information for system-wide quality improvement. The selection culminated months of effort and evaluation with input from the executives at IASIS.

Continue reading the article here:

http://health-care-it.advanceweb.com/editorial/content/Editorial.aspx?CC=98690

Four things struck me about this very frank article – other than that the authors points about clinician engagement were fundamental.

First I was surprised some one had gone out and developed and EHR for Bariatric (Obesity) Surgery hospitals.

Second I was very surprised that there was not more discussion of the need to involve all clinical staff (nurses especially) in the selection and implementation processes – right from the very start.

Third that it was just assumed that improved Health IT could assist in acquiring the desired Center of Excellence certification for bariatric surgery. I fear we have a way to go to reach the situation where such an assumption would be buried in accreditation and certification criteria in Australia.

Fourth was the implicit plan to use the Health IT to facilitate quality feedback and continuous improvement using information resources. What an excellent idea that we would all like to see more of.

Well worth a read for all the clinician engagement tips and tricks.

David.

1 comment:

InformaticsMD said...

Circa 1999 I wrote this:

Unfortunately, there is often a "whitewashing" of these issues in publications about healthcare IT. Remarkably, healthcare IT publications commonly offer articles acclaiming the value of IT personnel allowing clinicians to participate in clinical systems implementation. Clinician involvement is so obviously necessary that such articles might be compared to the New England Journal of Medicine publishing articles on the value of employing sterile technique during surgery. A critical reader should question why articles about IT personnel needing to allow clinicians to participate in healthcare IT still appear in print.

This statement now resides in the introductory essay at my web site "Sociotechnologic issues in clinical computing: Common examples of healthcare IT failure, and I stand by the "sterile technique during surgery" statement. This issue is so patently obvious to anyone who's spent time in the clinical world, that it should be considered embarrassing that these articles still have an audience.

Articles with titles such as "Importance of Physician Leadership in EHR Selection" should make enlightened people (i.e., those who do not blindly accept technological determinism) question the gaps in insight in today's non-clinician healthcare IT leadership.