In a recent CMIO article, John Halamka (MD, CIO of Beth Israel Deaconess Medical Center) offers a compelling reason as to “Why every hospital larger than 50 beds needs a CMIO.” As usual, his argument was well thought out, poignant and, as always, dead accurate. That said, it was not the lead topic that struck me but rather a single point within the context of the article, “Clinical applications are only as good as the processes they automate.” While seemingly so obvious, this essential component is often overlooked. As healthcare providers race to become fully electronic and meet meaningful use requirements, there is often little time to stop and re-evaluate legacy processes. But what is the risk if you don’t? Well, to name a few: extra costs, loss of productivity, and ultimately undermining the very thing you are striving to do which is make your data more meaningful and useful.
Manual processes are not independent of digital processes and vice a versa. Unfortunately, there are far too many “me too”, here-today-gone tomorrow vendors out there looking to capitalize on today’s health IT boom. With limited, if any, expertise in healthcare space these vendors are poorly positioned to help you uncover and address inefficiencies in existing workflows. This lack of expertise often proves disastrous. In fact, an Accenture study of 15 CIOs found that most underestimated the time and costs associated with implementing advanced EMR by nearly 100%. Why is that?
Well, clearly there is the fact this is uncharted territory. When the mandate to transition came out, it was gray at best, leaving many of the guidelines and regulations subject to interpretation. And, with meaningful use deadlines looming, healthcare providers had no choice but to dig in and get the ball rolling knowing full way they may need to adjust or “auto-correct” their strategy as they go. But, another factor for consideration is the fact that this is not purely an IT issue. It’s much larger.
Health IT considerations must extend beyond the cheapest software, fastest implementation, or interface functionality alone. Yes, all of these are important but it’s important to look at implementation holistically. In order to implement a solution that fully meets your organizations’ needs, and generates the long term costs savings you are hoping for, you’ve got to evaluate the entire transition spectrum – from paper to electronic. This includes building a plan that will reduce your organizations dependency on paper (and, in turn, the cost of managing that paper) and facilitate large-scale adoption of the EMR. To do that, you must have a clear understanding of how your paper processes work today. For example, what types of information are being recalled most frequently, how is that information being used, and when do requests to retrieve information drop off? This understanding will enable you to convert only the information needed, avoid cluttering your new system with unnecessary information, and ensure your clinicians maintain accessibility to all the information they need – before, during, and after the transition. This is essential not only from a usability standpoint but also a long term manageability standpoint. Keep in mind, whatever is entered into your electronic system will need to be managed and maintained over the long-term. Even under the best circumstances, the large volumes of information that will need to be converted in order to facilitate an EMR transition will lead to a data boom that will undoubtedly strain your current IT infrastructure.
However, should your EMR transition be initiated without proper consideration of workflow and use cases, you will undoubtedly find yourself facing the very inefficiencies that were driving up costs and inhibiting productivity in your organization in the first place. That includes the inability to find information quickly, managing inefficient “work around” systems and processes, and the additional – yet very avoidable- cost of holding onto paper records for far too long or archiving and backing up digital information that never needed to be carried over the EMR in the first place.
Related Links:
- If You Think A Successful EMR Transition Is All About the Data, Think Again – It’s All About the Docs
- Design the Optimal Healthcare Records Retention Schedule
- When Process Efficiency and Technology Become Personal
- A Booster Shot for Healthcare Data Archiving
- The Digital Revolution Almost Killed Me – And Healthcare Just Might Be Next
