ICT Implementation Best Practices

My previous posts touch on how ICT, in the form of EHR, CPOE and CDS, can benefit hospitals. Of course, the implementation cost for these technologies varies depending on many factors such as hospital size and technology scope. But in general, they are not cheap. As illustrations, Dartmouth-Hitchcock Medical Center spent about $80 million to implement EHR, University of California - San Francisco Medical Center spent about $150 million, and Duke University Health System spent about $700 million (Yes, you read it correctly, it’s $700 million). As far as federal government incentives go, the Medicare and Medicaid only provide them to the hospitals who are meaningfully using the EHR system. The definition of “meaningful use” is explained in more detail here. But basically, a hospital needs to achieve several objectives before it can claim the reimbursement. This includes making sure that all stakeholders are devoted to use the technologies.

Duke University Health System
It's gonna be $700 million, please. Debit or Credit?

Therefore, it is very important for hospitals to get the full benefit from EHR and other systems by performing the “meaningful use” of the technology. In this post, I will share some best practices how to achieve that.

1.      Full engagement of all stakeholders is the key

EHR and other technologies implementation are not IT department projects. IT department can install the technology quickly and easily. The projects, however, are more complicated than just installing software. These technologies would change the entire hospitals approach and operations. It is wrong to assume that each stakeholder will adjust his/her habits accordingly once a technology is put in. Rather, hospitals would need to secure the opinions and recommendations of the staff. This will eventually lead to their cooperation and commitment in the future. Therefore, the implementation team should include representatives from different hospital areas identifying requirements and implementation elements.

Key: All Stakeholders Involvement

 

2.      Physicians should take the ownership

Implementing EHR and other technologies for the first time will temporarily put burden on the physicians, who might be overworked and overloaded already. As instance, in the beginning it might take a longer time for a physician to input an instruction using CPOE compared to write it on the paper. This will bring frustration. Therefore, it is very important to let the physicians take the ownership of the implementation. That way, hospitals will get the implementation process moving forward.

3.      Educate and Train All Stakeholders including Employees, Physicians, and Staff

Education and training will help smoothening the transition to a new system. Hospitals would need to do this via workshops and seminars, internal marketing efforts, and education campaigns. It is also important to share the implementation milestone, so the stakeholders are aware of the progress. Hospitals also need to recognize some preferences and needs of the stakeholders. For instance, during EHR implementation process, hospitals should not try to force all physicians to do exactly the same thing. Hospitals need to provide several ways to accomplish the same task and offer physicians some flexibility to choose what will fit their practice style the best. This will add the training complexity, but it will guarantee a more successful implementation.

4.      Beside Implementation Team, Optimization Team is also Needed

Optimization team’s main task is to identify and implement improvement opportunities. This especially important during the mid-process of implementation. The other tasks include, but not limited to, identifying the best practices learned by the hospital staffs and retraining the stakeholders the updates based on trials and earlier outcomes.

5.      Duplication and Plan B are necessary

Redundant data entry must be minimized. However, the hospital administrators need to have a backup system or at least, a plan of action if the system is suddenly down or not functioning as it’s supposed to be.

                The cost to build a redundancy and backup system is worth the benefit.

 

 That’s it for now! Stay tuned for my next post!