Reasons that Organizations Should Not Implement the Electronic Health Record (EHR)

If there were a big red STOP button inside a facility sometimes I would push it. We have all seen the EASY button from Staples office supply stores well implementing and EHR is not easy. As a consultant, I have the opportunity of visiting different health care facilities. From time to time, I see organizations that are not ready for the implementation of the electronic health record. There are many reasons that organizations should not implement the EHR just yet.

I guess the biggest hurdle or challenge that I see for most organizations is that not everyone is on board with the concept. There will usually be a person or group of people that are supportive of the idea of implementing the electronic health record but they cannot see past themselves to the rest of the organization and how they perceive the idea. This is major obstacle. An organization needs for everyone to be on board with the implementation project. I have seen Health Information Management directors step forward and get a group together and present the idea to the CEO and the project is off and running without the support of clinical personnel. On the other hand, I have seen clinical personnel spear head the EHR implementation project from the clinician perspective and have the support of the physicians but administration wasn’t behind the project. The point is that to be successful everyone needs to be in agreement from the beginning. There needs to be a team approach to this type of project. So many projects are implemented to prematurely.

The second challenge that I see is that the EHR team selects the wrong product for their organization or facility. I have seen organizations select products that are great from the software aspect but then they couple their product with purchasing small notebooks for the physicians and clinicians to use. The physicians or clinicians are so frustrated because of the size of the keyboard on the notebook. Another obstacle is how that the note books or computer terminals are integrated into their work flow process. Computers need to be place strategically. If this issue is not addressed up front the whole project can be thrown to the side in a matter of months. When I asked about this purchase of small notebooks at one particular facility I was told that the purchase was due to a savvy computer vendor wanting to make an excellent profit on a package deal of notebooks. Hindsight taught them that the vendor sold them on all the benefits of the computer but did not assess their unique situation. The vendor did not take into consideration the size of the physician hands or his/her eyesight.
Another facility that I have been working with has a real concern for making sure that the EHR vendor that they choose is able to supply technological support 24/7 because they only have an on call support system with their existing computer system currently and they realized with having an EHR that it would encompass more technological expertise and assistance than what their own staff can offer. So choosing the right product and support for this organization is also very important.

The third challenge that I see is that the staff is not adequately trained on the EHR. The initial training and the ongoing training support really needs to be spelled out clearly in the contract. What is optimal training? How is training conducted for a high turnover of personnel? Who is responsible? How will the training be conducted? Is there an assessment done on the staff before the implementation begins to meet the staff‘s training needs? So many vendors come with a packaged product that offers the product and a set amount of training but what if your organization requires more, how is this handled? I have seen specialty facilities or clinics go in together to purchase the EHR product for their practices and then they hire an individual to be the trainer. This is a train the trainer approach and can be very cost effect if the two or three clinics are close to each other.

The last challenge that I have seen is that so many organization just do not have the funding for the full EHR project. They want to get on board and be the first and they do it at the expense of others. This is scary and sad. There are many ways to be creative and seek funding. I see that some organizations are holding out and waiting to see what our government will do to off set the expense. Some organizations have formed together and written grants and been able to fund their project that way. Yes, it is true that these types of projects are expensive. The only true way to make sure that you are getting a good return on your investment is to use a tried and true formula. People + Training + Product = Process. So many organizations really do not look at the overall process. They jump in with both feet and start looking at the products and what the vendor will offer. To be successful with the HER project, an organization needs to look at their workflow processes. To learn more about this please visit my website at www.healthcaretracker.org

Tags: EHR, health care industry, HIM, implmentation, workflow processes