HISTALK, one of may favorite site to get up to date HIT news, updates, and opinions, came out with his “Universal Rules for Big EMR Rollouts.” Just recently going through a GO-LIVE, I can very much relate to his talking points.
——————————-
1. Your hospital will pledge to make major processes changes, vowing
to “do it right” unlike all those rube hospitals that preceded you, but
the executive-driven urgency to recoup the massive costs means the
noble goals will change to just bringing the damn thing up fast,
hopefully without killing patients in the process.
2. The project and/or system must be anointed with an incredibly
dopey and user-embarrassing name, preferably chosen from user
submissions and with the offer of crappy vendor paraphernalia or lame
IT junk as a prize, and also preferably made up of a far-fetched phrase
whose contrived acronym spells out a medically related word or female
name. Instead of inspiring the expected collegial chumminess among
users, it will serve as a bitter reminder of the innocent, naive days
between RFP and go-live before it got ugly.
3. Doctors won’t use it like you think, if at all, because hospitals
are one of few organizations left that doctors can say ‘no’ to.
4. You’ll spend a fortune on mobile devices and carts that will sit
parked in a corral due to the short life of their $100 battery and a
dysfunctional but not yet fully depreciated wireless network, the
keystone arches to the entire project.
5. All the executives who promised undying support to firmly hold
the tiller through the inevitable choppy waters and who overrode all
the clinician preferences in a frenzy of inflated self esteem will
vanish without a trace at the first sign of trouble, like when scarce
nurses or pharmacists threaten to leave or when the extent of the
vendor’s exaggeration first sees the harsh light of day in some
analyst’s cubicle.
6. It will take three times as long and twice the cost of your worst-case estimate.
7. You’ll pay a vendor millions for a software package consisting of
standardized business rules, then argue bitterly that all of them need
to be rewritten because your hospital is extra-special and has figured
out the secrets that have eluded the vendor’s 100 similar customers.
The end result, if the vendor capitulates, will be a system that looks
exactly like the one you kicked out to buy theirs.
8. You’ll loudly demand that the vendor ship regular software
upgrades to fix all the bug issues you submit, but then you’ll refused
to apply them because you’re scared of screwing something up with the
skeleton maintenance staff you can afford, given that millions were
spent on systems with nothing left for additional IT support staff or
training.
9. All those metrics you planned to collect to show how quickly the
EMR would pay for itself instead show the situation unchanged or
getting worse, so factors beyond your control will be blamed (like a
ridiculously long implementation time that changed all the assumptions
and external conditions) and ROI will not be brought up again in polite
company.
10. No matter how unimpressive the final result toward patient care
or cost, the EMR will be lauded far and wide as wonderful since the
vitality of the HIT industry (vendors, CIOs, consultants, magazines,
HIMSS, bloggers) requires an unwavering belief that IT spending alone
will directly influence quality, even when nothing else changes.
Read and post comments |
Send to a friend
Comment posted by Katiebell
at 1/1/0001 12:00:00 AM
LOL….having Gone live now about 3 times in the past 3 months with a variety of different EMR’s and order entry systems, I tend to somewhat agree, but to be quite honest so far they have all been pretty smooth. All except for those rolling carts and batteries. We don’t want to chart in the patient’s room!!!! For The love of God and all that is good, some things go into charts that patients need not be privy too!!!!
Oh yes, definitely me writing what I did electronically really doesn’t affect the quality of care. but I will say as far as one system, the electronic T system, it creates a nursing note that is somewhat coherent, which the paper nursing T does not, so legally it covers my behind more….
