The Road to EMR adoption: A Q&A with Heather Haugen and Jeffrey Woodside, Part 1

By Jeff Rowe
03:46 AM

Researchers Heather Haugen and Jeffrey Woodside, MD, wrote their recently released book, Beyond Implementation: A Prescription for Lasting EMR Adoption, to highlight common themes to EMR adoption barriers that they were seeing in their work with clients and to provide a basic methodology for breaking through those barriers.

Earlier this week I sat down with Haugen, corporate vice president of research for healthcare IT consulting firm The Breakaway Group and co-director of health IT at the University of Colorado Health Sciences Center’s School of Medicine, and Woodside, former executive vice president and CMO for UT Medical Group, to talk about their book and research.

This Q&A is the first of three installments on To hear the complete interview via podcast, please go to

What do you hope your book will do for the industry?

Haugen: We believe our research uncovered the leading cause of poor and failed adoption of EMRs. For us that's really the persistent focus of either clinical leadership or vendors - maybe even consultants - on implementation rather than adoption, the go-live event, the installation of that software. We really hope that the book will help healthcare leaders define a comprehensive methodology for long-term adoption and they can look at this and at least customize it to what their organization really needs.

Woodside: It's probably helpful to define what our view of adoption is, and that is it is a very dynamic process that lasts the lifetime of the application. Implementation - or go live - is really the first step towards adoption. A good indication, we’ve found, of adoption is when every person in the organization is using the EMR according to the policies and procedures established by the organization. We believe that adoption is really required for obtaining the organization’s desired clinical and financial outcomes.

What kind of feedback have you gotten thus far from the industry?

Haugen: I think when you write a book, you sort of ask yourself the question of: Is this going to make a difference for people in the industry, specifically for folks that are going through the pain sometimes of an EMR adoption?

We asked several industry leaders to read the book before even the final publication. Both of us were thrilled to hear it resonated with them in some important areas. Bill Spooner (CIO of San Diego, Calif.-based Sharp Healthcare) was one of the folks who was an early reader and then also a supporter of the book and provided us with some feedback. It was also important to us to send it to physicians, so we got some feedback from folks who'd been through EMR adoption.

The feedback we got was that it reinforced our belief that maybe if organizations think about some of these things either when they start the process or as they are starting to go through some of this that they would avoid some of those common mistakes and maybe decrease the stress on the entire organization around adoption.

Across the provider industry, how difficult do you think it will be to change the definition of EMR/EHR success from implementation to adoption, especially given that many in the industry consider the two synonymous, and there is such a push for implementation?

Woodside: Actually, I think the ground right now is pretty fertile for defining EMR/EHR success as adoption. As you read through the meaningful use criteria, they really can't be satisfied without adoption of the technology. Simply implementing the EMR or EHR will not satisfy them. The application must be consistently used in the delivery of clinical care and then of course the more administrative aspects of the application.

Haugen: I think there are some important changes that have to be made. Jeff's right; it's the right time to be doing this. But I think for many of us, we're going to have to change the way we lead and how we behave when we're adopting applications. We talk about clinical and financial outcomes - because I know meaningful use really focuses on the clinical outcomes - but for many of the organizations we worked with the financial outcomes were important, too. But for many of them, they weren't getting to that point where they felt they could collect any kind of metric, and that piece is so critical as a feedback in the organization for how you're doing. And without it, I feel like you've really missed it. So I'm with Jeff; we're ready to do this. But it is going to require some differences in how we approach the implementation and adoption.

There are enough stories out there that most people are recognizing that adoption has to be the focus going forward.

Part 2 of the Q&A will run on Thursday, June 24.