As more and more hospitals merge, consolidate and continue gobbling up smaller practices, the endeavor toward a common electronic medical record seems reasonable and the anticipated benefits range from improved patient care to overall operational efficiency.
Although setting and pursuing this goal is a logical step toward automating data in the healthcare industry, most organizations have found the effort to be far from reasonable and have learned that the technology component is often the easier part of the effort focusing on the aspects of people, process and technology.
Melding disparate cultures, determining revised clinical practice patterns and programming levels of IT sophistication into a common system are a few examples that ultimately put significant stress on the people and process components of the endeavor.
Throughout my career, several information technology evolutions have taken place within the healthcare industry.
In the 1980’s, the industry experienced disruption as healthcare organizations began computerizing the patient billing function. Many a Chief Financial Officer lost countless nights of sleep as their organization’s revenue cycle progressed from paper to digital format.
During the late 1990’s, the need for further digitization in healthcare led to the proliferation of niche related applications which required data to be interfaced between disparate systems. These interfaces allowed for caregivers to have more access to data and reduced the amount of duplicate data entry required.
Lastly, with the encouragement of the Institute of Medicine’s “Crossing the Quality Chasm” the digitization of clinically related functions emerged throughout the early years of the new millennium. Each of these evolutions required organizations in the healthcare industry to “change.”
Whether a clinician, biller, ancillary support or administrator, all relevant professionals adjusted and adopted new roles and responsibilities. Each of these functions are now core to our daily lives. We could not imagine attempting to successfully operate a healthcare institution without these functions.
Today, organizations are challenged with the evolution to a common patient record. Implementing an integrated Patient Access, Patient Care and Revenue Cycle functionality brings with it many different goals, objectives and motivations. As a result, buy-in and adoption of the ultimately developed solution has been inconsistent across the industry.
With this in mind, key factors that serve to improve chances for success include:
1. Be clear up front that “change” will be taking place and that this change will be determined by fellow end-users across your organization
2. Have operational leadership drive the change with the support of IT resources
3. Employ “bridge builder” leadership to guide the change management process
4. Ensure all workflow changes have been properly communicated across the enterprise
5. The organization must take ownership of the project; rely minimally on the vendor to lead you through the effort
6. Do not make such projects IT-only projects
There have now been many well publicized short falls in attaining the anticipated benefits associated with the migration to a common electronic medical record.
Instilling a spirit of adapting to change and learning from the past among the end user community will go a long way in rapid use and adoption of the system.
Mike Restuccia is the CIO of Penn Medicine.