IT blamed in Athens EHR debacle

Recent news shows that clinical partnership is essential
By Mike Miliard
10:46 AM
Stethoscope on computer parts

Who's to blame when EHR implementations go south? There's often enough fault to go around. But when the fallout is bad enough, sometimes self-interested parties are all too ready to point fingers.

[See also: CEO resigns amid troubled EHR rollout]

In late May, we covered the story of a $31 million Cerner rollout at Athens Regional Health System in Georgia that didn't go as planned.

Thanks to what was described by clinicians as a rushed process, doctors nurses and staff were up in arms about a series of medication mistakes, scheduling snafus and other communication glitches.

[See also: IT and informatics play well together]

"The last three weeks have been very challenging for our physicians, nurses and staff," wrote Athens Regional Foundation Vice President Tammy Gilland, Athens Regional Foundation vice president, in a letter to donors explaining the situation. "Parts of the system are working well while others are not."

The complaints lodged by clinicians were soon followed by the resignation of President and CEO James Thaw and, less than a week later, Senior Vice President and CIO Gretchen Tegethoff.

This past weekend, on June 15, the Athens Banner Herald reported that Athens Regional's chief medical officer – as well as executives from Cerner – were pointing fingers at the health system's IT team, complaining that they made strategic decisions that should have been the bailiwick of clinicians.

"Could there have been more information shared at the administrative level? I suppose you could make that argument," Senior Vice President and CMO James L. Moore told the paper. "The implementation was through the CIO, and so that's where the information was held."

The Banner Herald's Kelsey Cochran also quotes a Cerner vice president, Michael Robin, who noted that while some end-users were involved in the rollout, it seemed primarily to be led by Athens Regional's IT team, which he said was "atypical" of Cerner sites.

Another Cerner VP, Ben Hilmes, told the paper that successful EHR implementations are "clinically driven, not IT-driven." At Athens Regional, he added, "it came out of balance toward the IT side of things."

Moore has since taken the lead on the project. Cerner has pledged to do "whatever we need to do" to help the process get back on track, Hilmes told Cochran.

Whether or not this is a matter of three different parties – IT, clinicians, vendors – circling the wagons around their own and casting blame on others, one thing is certainly true: On big projects like these, the technology side and the clinical side need to be committed and communicative partners from the get-go.

This past week, Healthcare IT News reported on the story of Corpus Christi, Texas-based CHRISTUS Spohn Health System, which has reaped the benefits of an initiative that seeks to ensure medical informatics has a key role to play, from the inception, in all its IT projects.

"We're wired a lot differently than the tech people are," said Marc Stearman, a physicians assistant, and director of health informatics at CHRISTUS, of his fellow clinicians.

In the past at CHRISTUS, there had been "a number of technology implementations and rollouts that weren't, how should I say, 'overly embraced' by medical staff," he said. To avoid that, it's critically important for IT folks to have "an acute sensitivity to clinical workflows and the end-user."

Bill Morgan, senior regional director of information management, said empathy and understanding on both sides – and perhaps a willingness to cede a bit of turf in the spirit of better cooperation – is essential.

"We, the IT people, are the standard-bearers for major systems initiatives within healthcare," said Morgan. "But we have to be willing to give up a little control, work collaboratively with our informatics counterparts and understand that that's not going to somehow diminish our standing.

"If you have the clinical leadership, and you're willing to make those cultural changes, Epic is going to work, Cerner is going to work, Meditech is going to work," he added. "The technology is there. It's about the comfort level with redesigning some of your processes to take advantage of the advanced technology. But if you're not leading change and looking into the future, you're not going to be successful."

Coincidentally, this past week also saw the news that the College of Healthcare Information Management Executives and the Association of Medical Directors of Information Systems were pursuing a partnership to better integrate efforts to serve their constituents on the IT and clinical side, respectively.

"CHIME strongly believes that the formation of closely aligned partnerships can enable true IT transformation and progress in healthcare," said CHIME President and CEO Russell P. Branzell, in a press statement.

"It has never been more important for all those who understand information instruments and patient care to come together to achieve the transformation of American medicine," added AMDIS Board Chairman William F. Bria, MD.

[See also: CHIME, AMDIS to join forces]