This fantastic blog appeared a few days ago.
Halamka offers lessons on Healthcare.gov's rough go-live
Posted on Oct 24, 2013
By John Halamka, CareGroup Health System, Life as a Healthcare CIO
CIOs face many pressures: increased scope, reduced timelines, trimmed budgets. After nearly 20 years as a CIO, I've learned a great deal about project success factors.
When faced with go live pressures, I tell my staff the following:
"If you go live months late when you're ready, no one will ever remember.
If you go live on time, when you're not ready, no one will ever forget."
I have hundreds of live clinical applications. Does anyone remember their go live date? Nope.
Were there delays in go live dates? Many.
With even the best people, best planning, and appropriate budgets, large, complex projects encounter issues imposed by external factors (new regulations, competing unplanned events, requirements changes) that cannot be predicted during initial project scheduling.
It helps no one -- the users, the business owners, or the IT department -- to slavishly adhere to a deadline when the project is not ready to go live.
I work on federal advisory committees in the Obama administration and truly believe in the goals of many administration programs: Meaningful Use, HIPAA Omnibus rule, and Affordable Care Act.
However, we've seen that in the interest of accelerating change, deadlines have been imposed that do not allow for sufficient testing, piloting and cultural change. The result is that haste makes waste.
As I've written in my blog many times, ICD-10 will become a crisis for the Obama administration. Payers and providers will not be ready by October 1, 2014. Documentation systems and clinician billing process changes will not be mature enough to support a successful go live. More time is needed. My experience with IT crises is that you can survive one at a time, but a succession of problems creates a pattern that users and oversight bodies will no longer tolerate. I hope the premature go live of the Health Insurance Exchange results in a review of ICD-10 go live dates.
Meaningful Use Stage 2 attestation criteria are good. The certification scripts need very significant revision. How did this happen? They were created in a rush to adhere to an artificial deadline, not reviewed by the federal advisory committees, and not piloted tested/revised. New regulation is needed fix them and that will take time. Again, the lessons of the Health Insurance Exchange should cause us to extend Meaningful Use Stage 2 deadlines by a year, deferring future stages of Meaningful Use until we have consolidated our gains and understood our successes/failures with current stages.
Lots more here:
Would it not be wonderful if there had been someone with the experience of Dr. John Halamka around a year or so ago when we had the mad rush to bring the PCEHR live in July, 2012.
As a result of that rush we are still trying to get it fixed up to the stage when it will be really useful a year + later.
The advice in the first few paragraphs is so right it hurts and must never be forgotten.
On a related topic this also appealed to me this week.
8 ways to manage change, not just HIT implementation
October 25, 2013 | By Julie Bird
There's a way to manage change associated with health IT, healthcare consultant Frank Speidel, M.D., says--eight ways, to be more precise.
Writing at HITConsultant.net, Speidel, chief medical officer for the Health IT staffing firm Healthcare IT Leaders, identifies what he calls eight "ates" for managing that change (check out the full post for more detail):
· Contemplate the changes IT implementation brings to the health system and its operations by convening a diverse group representing different elements of the organization.
· Communicate to understand "the why, where and what of the change" and where the change is taking the organization.
Lots more here:
Well worth a read for those involved in implementation.
David.
1 comment:
John Halmanka at his best. John's statement and your comments re the PCEHR are very appropriate. When I read stuff like this and refer to the PCEHR it is like chewing on Alfoil.
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