By staff writer, Linda Stotsky
For the last decade, healthcare organizations have been purchasing components of the technology “stack” from multiple vendors, assembling the random pieces, and hiring specialized staff to maintain the IT infrastructure. How can we unleash future innovation without adding an additional level of complexity? How can we improve the way we integrate systems and services by reducing the cycle of implement- rip-and replace?
Let’s face it, IT systems are quickly surpassed and insanely outdated by the time many of us learn how to use them. The conundrum of continuous improvement, lies in our inability to identify value-add vs. value-drain in design, education and training materials.
Twelve years ago, while working for a well-known “Top 5” healthcare company, I was asked to visit a reference account. I made an appointment with the EMR Analyst. He explained that after purchasing the EMR for xxx amount of dollars, no one was using it. I was shocked to find flags on the doors and paper charts in the holders. 150 users reverted to paper. Yikes! This was quite the challenge. I’d been in the EMR world for several years, yet never encountered such a strong anti-EMR statement AFTER purchase. I began meeting with each role-based user of the EMR. I analyzed alignment to work flow, process and business need. It was necessary, though almost impossible, to create super users. The natural reaction was to resist. Every individual I spoke with had a lack of awareness regarding the reason behind non-use, but they were confident in my lack of ability to resolve the issues.
This is what I heard:
- Time-consuming data entry
- Interfaces that hampered workflow
- The quality of clinical documentation was degraded
This is what I found:
- RNs were spending an inordinate amount of time working on orders in the EMR
- Integration with ancillary hardware and software was inadequate
- There was duplication of effort in time and process
This is what I did:
- Established trust
- Integrated all ancillary machines that could be interfaced with the EMR to reduce duplication in time and effort
- Added the missing pieces like “CC” forms, and medication templates for chemotherapy
- Lastly, I customized short-lists for each user, set up favorites, and rules
People resist change when they do not understand the implications
Buy-in requires more than an executive order. To simplify the change process, I listened to people, and began implementing changes that included their ideas.
The result of this re-org:
- Less time spent on redundant tasks
- Voice-enabled documentation to improve accuracy
- An EMR that became valuable for outcomes based research and data-mining
- 150 users grew to 250
How did I do it? I simplified the process of change, determining which processes needed to be implemented for optimal results. The tools and techniques employed were based on the present needs of the organization. It wasn’t rocket science. It involved listening, educating and empowering PEOPLE. Opportunities for improvement were identified and prioritized by the team. Optimal results were gained by working together to identify the key areas of improvement that would have the largest impact on project success.