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February 28, 2019
GET YOUR HANDS DIRTY: EFFECTIVE EHR PLANNING FOR HEALTH EXECS
By: Ulla Kuukka

Accenture expertise, blogs and sources of domain expertise provide guidance on how to help ensure the success of transformational health care programs. For instance, we know that EHR programs are not just IT programs and that engaging leaders is important. Based on a recent experience, I have found that it is easy to overlook the lessons learned from others. Why do so many EHR leaders keep repeating the same mistakes and think “… I am different, this does not apply to me”?

Concrete goals

EHR, like any other business transformation program, needs a set of clear, concrete goals—a North star that employees understand and can relate to. Oftentimes the goals are quite general: “one patient, one record” or “focus on care quality and efficacy.” But these goals must be translated into practical pointers for nurse managers or clinic secretaries, who need to understand what those goals mean for their everyday working life so that they can roll up their sleeves and implement the plan. For instance, if administrative staff don’t document all required fields for new EHR during patient registration, it will have a direct impact on billing. If the goal is to “lead with data,” nurse managers and chief physicians should use the available reports in an EHR several times a day, understand the implications of historical baseline data and new metrics.

Having a clear, communicated, lean governance model is vital to success. This might be easy on PowerPoint, but it’s harder in real life. Getting the governance model right requires effort, courage and a lot of leg work. Stakeholders should be identified—not just at the leadership level, but particularly at the middle management level. Middle managers are the ones who have the most impact on end users and the most insight about what works for them and what doesn’t. Getting the middle management involved and the required engagement action plan defined takes time—and many iterations. It should be done by getting one’s hands dirty, in collaboration with operational leadership and management. Not in the safety of a program office, where challenging realities might be avoided in favour of easier (but less effective) options.

Patient- and employee-centricity

We know that healthcare needs to be more patient-centric. It should also be employee-centric. What does it require to be truly employee centric? Most of all, a mindset. Also, design thinking methods have proven to be useful, relatively easy to conduct and engaging.

One concrete and useful way to engage end users and help them understand the future state is to create personas and patient pathways based on a stakeholder analysis. In addition to patient personas, it’s valuable to define personas for health care professionals such as a secretary at patient registration, nurse in the ward, surgeon in the operating room or psychiatrist in the consulting room. Each of them has roles and responsibilities along the patient’s pathway. Helping healthcare professionals understand not only their own roles and responsibilities, but also others, will give a much-needed big picture of who does what in the care continuum. Patient pathways can focus on areas where improvements are typically found; registration, medication management, patient transfer & discharge, and secure communication between different stakeholders. This should be done in a comprehensive way, with sufficient representations by each health care role, not as a quick leadership activity far from the true operations.

Modern healthcare is based on evidence and research. Healthcare professionals are committed in helping their patients. Healthcare developers should also use proven, engaging methods in getting tools and processes in place for them.

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