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EHR Change Doesn’t Always Mean Better

Posted on August 1, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In the comments of my post “EHR Replacement Roadmap to Success“, John Brewer provided a great reminder that changing EHR software doesn’t always mean that you’ll change to a better EHR. You might change to something worse. At least that’s my summary of his comments. You can read his full comment if you want.

I’ve learned this lesson over and over in my career. Sometimes you need to be content with what you have. One example of this was when I was working at a University in Hawaii. I was quite disappointed with the CIO and thought that he could do a lot of things different. Well, I got my wish and the CIO was replaced with someone else. Considering the topic of this blog post, you can imagine what happened next. The replacement CIO was so much worse than the previous CIO. Lesson learned.

Change doesn’t always mean a change for the better. It can certainly mean a change for the worse.

This applies fully to EHR replacement, which is quickly becoming a hot topic as many people regret their EHR purchase decision. You do need to be careful that you’re so afraid of change that you never change. In many situations change is the right decision. Plus, unlike my story where I had little control over who was hired as the new CIO, when you switch EHR software you can have some impact on the selection and end results. In many cases, you might even discover that you shouldn’t switch EHR before it’s too late.

I expect most people who think they need to switch EHR need to be careful to not set a predetermined course early in the process. Instead of saying, “Which EHR should I switch to?” I believe that many should dig deeper into the question, “If I switched EHR software, what would improve?”

As I replied to John Brewer in the post linked above, it is often (but not always) the case that the second EHR selected goes better than the first. I’ve found that the first “failed” EHR implementation usually teaches some great (albeit costly) lessons that they’re able to avoid the second time around. However, there is a tendency the second time around to focus too much on the first EHR issues that can cause different trouble the second time around. As in most things, there’s a balance to be had.

My best suggestion is to not do anything too impulsive. Let the idea sit and germinate a little before you do anything too drastic. Emotional decisions with EHR software selection (and quite frankly many other decisions) often leads to bad outcomes.

What We Can Health IT Learn From Dancing with the Stars

Posted on March 18, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

A lot of my readers probably don’t know that along with creating the Healthcare Scene blog network, I also have a network of talent reality TV blogs. For some reason, people don’t understand how a techguy could start a health IT blog network and also cover shows like Dancing with the Stars and So You Think You Can Dance. There’s so much synergy between the two networks. Ok, not really, but I’m always surprised how many people in healthcare IT watch these shows as well.

Since last night was the premiere of Dancing with the Stars, I thought I’d apply some of the things I’ve seen in Dancing with the Stars (DWTS) to healthcare. For those not that familiar with the show, this is the 18th season of DWTS and that’s a great run for any show. However, the ratings have slowly started to dip for the show. DWTS has always done well when it came to total viewers (10+ million), but has always had issues attracting the viewers advertisers want to pay for (adults 18–49). The past couple seasons they’ve made some tweaks to the show, but this season they’ve made quite a few major changes to the show to try and engage a new audience and reach that special adults 18–49 demographic.

Now let’s compare this to healthcare IT. How many healthcare organizations are found doing a balancing act between the younger tech savvy crowd and the more risk averse older crowd? I think a lot of them are and more will be doing so in the future. On the one hand you have the doctor who is ready to retire early because she doesn’t want anything to do with EHR and health IT. On the other hand you have the resident who hates going to a practice that doesn’t have an EHR because he can type faster than he writes.

Much like in DWTS, if you cater to the one, you alienate the other. It’s a tough balance. Last night on the premiere of DWTS the show made a number of major changes to try and cater to the younger demographic. I have dozens of emails from the older demographic complaining about the changes. Most are crying for the good old days when they had something that was familiar and the way they liked the show to be. Many of them felt alienated and wondered if the show cared about them.

Does this sound a bit like what some of the health IT therapists (sometimes called CMIOs) feel when they’re talking with some of their older colleagues? They feel alienated by the new technology and long for the good old days. I’ll never forget the nurse who told me she hated EMR because she couldn’t draw the male and female gender symbols. For some reason it was so much better than the Male/Female drop down box (which is ironic because I’m not sure how she drew Male to Female Transgender, but the dropbox handled it just fine).

Much like Dancing with the Stars, there comes a point where you have to do some things that will alienate some of your most ardent fans in order to grow and continue to be viable. Finding the balance between too much alienation and too much catering to the new crowd is a very tough challenge. However, every organization needs to take these risks.

The key to all these changes is creating a culture around change at your organization. Most organizations try the big bang style of healthcare IT implementation. Sometimes it’s necessary, but it’s not the best way. The better way is to create a culture where the organization takes a thoughtful approach to implementing great technology as part of the normal business method. Make sure that whatever changes are implemented have a purpose and it’s communicated well. The combination of multiple small changes made in your organization can accomplish far more in your organization than the big bang IT implementation. Plus, all those small changes add up to a big change for your organization without the same end user alienation.

Balancing EHR Change vs Train

Posted on May 21, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I was talking with Heather Haugen from The Breakaway Group (A Xerox company) today and in our discussion she used the word “train”, but I heard the word “change”. I always love a good play on words and so it was interesting for me to consider the difference between change and train in an EHR implementation.

Every EHR implementation I’ve been apart of walks a fine line between users wanting the EHR software to change versus the need for an EHR user to change. One of the most common phrases out of a doctor’s mouth during an EHR implementation is, “Why did the EHR vendor implement that feature like this? Did they not talk to a doctor? This makes no sense.” We’ve dug in previously to the concept of EHR vendors consulting doctors during their EHR development so we won’t go into that further now. Every EHR vendor consults doctors, but no two doctors practice alike. So, it’s normal that every doctor would wonder why certain features are implemented the way they are implemented.

When faced with this issue, the doctor is faced with an important decision with two options. The first option is to work with the EHR vendor and convince them to change how their EHR works. In a large hospital EHR vendor situation, this can be almost impossible. Plus, even if that EHR vendor does like your suggested change it’s going to take months and sometimes years before that change is implemented in the EHR software, tested, and released all the way to you the end user. Yes, these changes can go faster with a SaaS EHR, but it still will likely take months before the change reaches the end user.

In some cases, you can wait for the change to be made before using that EHR feature. However, more often than not a doctor is going to have to train on how the EHR vendor has implemented the feature. This highlights to me why having great EHR training is so important. Sure, many of the things in an EHR will be intuitive, but great EHR training is still always beneficial. EHR software is too complex to just pickup and use. Plus, even if you can use the basic EHR features, good training points out the ways to optimize the EHR workflow.

Most doctors don’t understand why various parts of an EHR workflow can’t be easily changed. They just think change should happen easily. Ironically, the doctor then proceeds to resist any change to how they want to work.