As EMRs continue to rise, many projects fail. Why?
EMR adoption is growing. While there are success stories, many projects also fail. How can you avoid the pitfalls? In my experience, there are five key common misconceptions that need to be dispelled. They may seem like common sense, but many people still hold them:
Healthcare is changing. Rapidly. In fact, patients are driving the introduction of Electronic Medical Records (EMR) around the world. The Accenture 2016 Consumer Survey on Patient Engagement shows consumers of all ages are accessing their EMRs. They know more about the data that is available to them than two years ago, and most say that the benefits of electronically accessing medical information outweigh the risks. Also, more consumers say the benefits outweigh the risks in 2016 than 2014.
While not solely driven by consumer demands, the adoption of EMRs continues to rise and will continue to do so. While many of these projects may be successful, many projects fail every year. Why? What can you do to help ensure and avoid the pitfalls? In my experience, there are five key common misconceptions that need to be dispelled. While these may seem like common sense to most, a shocking number of organizations still either hold them, or as the project commences or gets busy, lose focus and get off track. These misconceptions are:
Assuming that EMR is an IT project rather than a business transformation, that the CIO is in charge and the rest of the organization will willingly follow;
Software goals will automatically be achieved with flipping the switch;
Pragmatic leadership is sufficient;
Full software functionality is all that is required for delivery of the required benefits;
EMRs are important only to healthcare organization – however, it is crucial for them to realize that EMRs are important to patients as well.
Why do some organizations fail and others reach new heights in care delivery, and how can you be sure to reach the goals you set out to deliver for your organization?
Have clear, agreed goals
While this seems straightforward, different leaders can have reasons for embarking on an important EMR journey. Does your Chief Medical Information Officer (CMIO) have the same goals as the Chief Financial Officer (CFO)? What about your Chief Nursing Officer (CNO), or Chief Information Officer (CIO)? How do their goals support or conflict with one another? Recognize these differences and develop a clearly defined strategic plan, allowing the goals to be directly aligned with your EMR initiative. Ensure that all CXO priorities, and incentives, are aligned with program and clinical transformation goals.
Creating a strategy is an important first step, but isn’t the only responsibility your senior leaders have on the EMR project. Ongoing commitment from engaged, respected leaders is paramount to the engagement of the larger organization and project team. While the overall project may be led by a dedicated project director, a key leader, or leaders should be identified and serve as the official sponsor(s) of the project. Due to the complexity and far-reaching impact of an organizational EMR transformation project, this sponsor is often the Chief Executive Officer.
Establish governance early and use it
Having created a strategic plan and identifying a respected, visible project sponsor, some might think they are set up for success – but the work is just beginning. These leaders should not just relinquish ownership of the project to the Project Director to deliver results in the next 18-24 months. A well-conceived governance model is needed, with clear responsibilities for each level and member of the governing board. Throughout the life of the project hundreds, if not thousands of decisions will impacting various parts of the project. One way to work smart (as many organizations do) is to extend the same governance structure used during vendor selection through the life of the project.
It’s not ONLY an IT project
For most organizations, EMR is the single largest project they have ever done. The assumed technical nature of these projects means many regard them as IT projects – to be managed solely by the IT Department. While it is probably the single department with the structure and methodologies most suited to successfully implement EMR, most issues that plague large IT projects are related to people rather than technology: workflows improperly harmonized with the new technology, end users not adequately trained prior to go live, physicians not engaged in the change process – these are the kinds of reasons EMR projects fail. Organizations that succeed, recognize the transformation aspect of these projects early on, and develop appropriate change enablement strategies.
Give Change Enablement a Chance
Electronic Medical Record projects are likely to affect more of your employees than any other project. Remember that the real goal is care transformation – which changes the way your staff work, the way they care for patients, the way they present themselves to patients and the way patients interact with them. Real change enablement goes far beyond training and go-live support. Unfortunately, most organizations limit themselves to these two aspects. Change enablement should start with the project, and enjoy as much importance as design, build, testing and training.
The good news is: you are not alone."Seek out those with experience. Learn from their successes, failures and ask them what they would do differently."
Mark A. Anderson
You aren’t the first to experience the highs and lows of a business transformation MR project on an EMR foundation. Seek out those with experience. Learn from their successes, failures and ask them what they would do differently. Whether it’s creating unified health- and social care records in Finland, the One Citizen One Journal initiative in Norway, legislation-driven change like the US Accountable Care Act, or meeting consumer demands by adopting systems with greater flexibility and integration, the message is clear: all healthcare organizations must meet new requirements swiftly and efficiently.
Plan your journey and set aside moments to celebrate success. Maintaining a sense of accomplishment within your team is critical. This work can, and should be, fun!