HIMSS recently gave the University of California San Diego Health System (UCSD) an award for reaching the highest level of advancement in electronic health records.

But while the UCSD team should take pride in its achievement, policymakers may have a thing or two to learn from how the organization made its way to the forefront of the HIT transition.

To receive the HIMSS Stage 7 award, “an organization must have a complete EHR system, including computerized physician order entry, physician and nursing documentation, closed loop medication administration, clinical decision support, ancillary systems, a data warehouse, and the ability to exchange information with other healthcare systems.”

Needless to say, that puts UCSD in some pretty select company, but what’s perhaps of greatest interest is how the organization got there, and how long it took to do it.

According to UCSD’s CIO, “the key to getting this far . . . was his organization's realization, about 10 years ago, that the purpose of information technology was to improve patient care. Without that vision, he says, it would have been difficult to get the traction required to make so many changes.”

In other words, even assuming everyone’s on board, it can take many years to accomplish a wholesale switch to HIT.

At first, “the organization was using a legacy information system that was old and slow but that it was contractually locked into. (The CIO) says he scored his first big success by making a few programming changes that converted that system into something that helped clinicians do their work more efficiently. His team replaced the software's green screens with a graphical user interface; ensured that the system was available 24/7; and installed a file cache that greatly improved system performance, so physicians could call up lab results almost instantly.”

Next up was CPOE, which was introduced in just one of the hospital’s departments as a trial. After that came integrating CPOE throughout UCSD’s pharmacy system, then the introduction of an electronic medication administration record.

All that was done with the group’s existing IT system, and the next step came with the effort to upgrade to a new, “more capable IT system.”

Two things catch our eye in this tale: the timeframe, and the methodical steps taken as the organization took one step after another into the HIT future.

For policymakers and stakeholders wedded to HITECH’s current schedule, it may be time to accept the fact that change usually takes longer than we’d like it to.