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EMR Job Seekers Get Their Big Break

Posted on January 11, 2012 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

I’m not a big fan of reality shows, especially those that involve contestants singing, telling jokes, dancing, or anything else that could potentially result in public humiliation. I’m in the minority, of course, as this style of television programming shows no sign of abating anytime soon. It’s a worldwide epidemic, in my opinion.

I am a fan of creative marketing – applying concepts traditionally associated with one particular medium (like television) to something entirely different (like healthcare). Needless to say, the Big Break job recruitment program – you could also call them auditions – intrigued me.

In a nutshell, pre-screened candidates take part in a one-day audition process put on by recruitment firm Intellect Resources and participating hospitals. Candidates then compete to become trainers and instruct staff on the use of the sponsoring hospital’s electronic medical record system or related healthcare IT system.

Seems like a slam-dunk concept, in my opinion. Those who are unemployed get a job within their community, and also get a taste of what that popular 15 minutes of fame is like. Did I mention that candidates go through video interviews and public presentations during the daylong process?

I recently chatted with Tiffany Crenshaw, President and CEO of sponsoring organization Intellect Resources, about how the program came about and the impact it has had on its participants’ lives (and go-lives).

How did the Big Break come about?
Tiffany Crenshaw: The Big Break spawned out of a project we were working on at Mt. Sinai Hospital last year. Last fall, they were getting ready for their Epic training and called me in a panic. They were expecting to get 90 to 100 trainers, and were going to use nurses, but realized at the last minute that wasn’t a viable idea. So they called us and said, “We have to do something now – we have no budget and we have no time. And we want to do some sort of done-in-a-day type audition. What can you do?”

So we said this is right up our alley. We created a really cool event – it was at the big Marriott Marquis in Times Square. We had around 500 contestants, and they all went through a timed audition process – stressful for them, but it was still fun.

They had to go through seed interviews and get in front of cameras. They had to get in front of a boardroom of judges and do presentations. At the end of the day, we ended up with 100 trainers that worked at Mt. Sinai to help roll out the hospital’s Epic training and go-live.

So that’s really the model of Big Break. We created it as a solution for Mt. Sinai, and now other folks are getting the word about it. Ochsner Health System is our next one. We’ve got the Big Break event for them in just a couple of weeks (January 21).

Did they reach out to you?
A consultant and dear friend of mine that was actually helping them with their system selection and project planning for their Epic implementation recommended this business model, and brought us in as the vendor to run this product for them. So yes, they did reach out to us, but it was really a consultant that made it happen.

Are you an all-Epic recruiting firm?
At the moment, that’s just about all we’re doing. Through the years, we’ve worked with many other products – with McKesson, Cerner, Siemens. The demand right now is Epic, so by default we’re doing all Epic. That’s just where the demand is, and so that’s where we’re spending our time.

How have you seen this type of program impact sponsoring hospitals and surrounding communities?
We think it’s a business model that works very well for hospitals. It’s a very low-cost way to get good resources. It’s also a good marketing opportunity for them to promote the fact they’re installing an electronic health record to the benefit of their patients, and it’s a great way for them to reinvest in their own community.

At Ochsner, the idea is that this is really for the New Orleans community. They don’t like to hire outside consultants. They really want to empower and revitalize their own community.

Many of the folks that we worked with at Mt. Sinai have gone on to work at other places. Big Break was really their footprint in the door. The end result is that the consultants that come through with really good experiences.  Over 50 percent of them are now working in the industry. Mt. Sinai actually hired four full-time employees. There was a big project up in Rochester, N.Y., that a lot of the people went to after that first project. We redeployed probably 20 of them on several go-lives.

Is there an opportunity for this to work in other cities?
At our very first meeting with Ochsner’s project executive, we talked about the fact that there are several area hospitals in and around New Orleans gearing up for Epic implementations. Our original thought was, let’s do this together, but the go-live timeframes didn’t work.

It would make perfect sense if there were multiple hospitals that could do the event together, do the credentialing together, and then take people from a generic credentialing and deploy them to the individual hospitals to learn the individual builds. I think it’s a model that could be a really good collaboration.

I think one of the neatest things about Big Break is that this industry is so thin on the amount of really good resources that are out there. It’s a great way to breed new talent

One Student’s Perspective on Electronic Medical Records

Posted on December 7, 2011 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

I’ve had the good fortune in the past year or two to watch one of my daughters’ favorite babysitters blossom into a full-time nursing student at the University of West Georgia. Not only do my girls benefit from her great bedside manner, including an infinite amount of patience, but I get an occasional inside glimpse into the world of digital medical record keeping in the greater Atlanta area.

Her training at West Georgia has taken her to Children’s Healthcare of Atlanta – Egleston, Wellstar Cobb and Austell, Fayette Piedmont, Tanner Medical Center and Gentiva Healthfield Hospice. She graciously offered to share her rookie’s perspective on the electronic medical records – including SCM/Quest (Allscripts Sunrise Clinical EHR system) and Meditech – she has used at several of the facilities she has trained in.

How long have your healthcare training facilities had EMRs in place?
All except Gentiva Healthfield Hospice – in-home hospice care, for the most part, sticks with paper charting. If they were to make the switch to an EMR, they would have to have access to a central database from their personal computers/iPads/Blackberries, etc. All others have had some sort of electronic database for at least five years.

How intuitive did you find them to be in your first training sessions/rounds?
Once I had been trained in the first system I encountered, the rest seemed very user-friendly. They have been in use long enough now that they are efficient and fairly self-explanatory.

They all allow an employee to cluster patient care and spend enough time with the patient because the time stamp on documentation can be changed to the time that the intervention was completed. For example, I could complete a full assessment on a patient, bathe them and administer their medications without having to document in the computer every few minutes. I could just open their EMR after completing their care and add the correct time stamp on my documentation.

What were the easiest to use, and what were the most difficult?
Meditech was the most difficult to use, perhaps because I had limited access as a student. It was difficult to find complete admission notes and patient histories.

Speaking from a “rookie’s” perspective, what would you tell vendors of these systems to better their products?
Add a patient verification requirement before each documentation session, i.e. each set of vital signs, medications given, etc. (Something simple, like a box with the patient’s name and DOB and an “Ok” button)

Did your supervisors express any enthusiasm or dissatisfaction with any particular systems?
All expressed enthusiasm, but they also were concerned any time a system was to be updated with even minor changes. Fayette Piedmont uses one EMR system for Labor and Delivery, and a completely different system for the rest of the hospital. This means, for the staff, that a new baby’s records have to be re-entered into a new system once they are discharged from labor and delivery and admitted to the NICU or postpartum unit. It also means the pharmacy has difficulty accessing vital information when, for instance, they need to know a baby’s weight to send the appropriate dose of medication to the NICU.

How aware are you of post-implementation training that goes on with EMRs, based on the facilities you’ve trained at? Do your supervisors ever mention it?
Once an employee is hired, they usually must display proficiency with the charting system within a specified training period. When Fayette Piedmont updated SCM/Quest, they did not retrain each employee, but they did send out a packet with a detailed description of the changes. From what I have seen, the older nurses who may have preferred paper charting at one point do not seem to have any problems with the electronic charting.

Have you been made aware of any increase/decrease in positive clinical outcomes as a result of physicians/nurses using these systems? Any examples you feel comfortable sharing?
The major changes to these systems each time they are updated usually involve the addition of safeguards. For example, the newest version of SCM/Quest has the patient’s name, weight, room number and allergies on every page of the charting system, and in multiple locations on the page.

For the employees who pay attention, this has reduced many documentation errors. There is also an embedded link to drug guides in every electronic medication order with explicit instructions and safe dose ranges. For the employee who knows these features are there, they are a tremendous help, and they do serve to protect the patient. It is still possible to document in the wrong patient’s chart, without realizing it, in any system.

Needless to say, it will be interesting to see how her experience with EMRs changes as she continues her studies and then moves into the professional world of nursing, which will likely coincide with healthcare facilities continuing to move through the various stages of Meaningful Use.

Stay tuned for next week’s post, in which I’ll profile an EMR educator, and find out what other students are facing when it comes to EMR training. In the meantime, what sort of healthcare IT-related challenges will our new workforce face in the coming year? Please share your thoughts in the comments below.

A Little EHR Education Could Go a Long Way

Posted on November 23, 2011 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

I’ve always got my eyes open for news of healthcare facilities marketing their healthcare IT systems to patients. To me, explaining the new high-tech gadgetry at check-in and the new computers/laptops/tablets in each exam room goes a long way towards making patients feel more comfortable before, during and after a visit to the doctor or even hospital.

I came across two recent examples of patient outreach that I think are great ideas, and would certainly get my attention, and perhaps even get me to consider switching providers.

The first is an ad from Martin Memorial Health Systems in Florida, promoting their transition from paper-based records to an electronic medical records system (Epic, if you must know.) News of the implementation in a recent HISTalk post mentions that the ad is part of a campaign announcing the system’s transition starting in December. I couldn’t find any mention of the campaign, or the transition, on the hospital’s website, so I’m not sure where exactly this ad will appear – hospital hallways, local newspapers, etc.

The second comes from Kay Gooding, Project Director of the Region D Health Information Technology Consortium at Pitt Community College. She alerted me to HealthIT.gov’s Campaign Toolkit – a variety of online resources that organizations can use to educate the general public about healthcare IT. The toolkit includes a short video (see below) on Ensuring the Security of Electronic Health Records. I could see this being played in hospital lobbies, doctor’s waiting rooms, or even embedded in some sort of physician-sponsored new patient welcome site, which could also house medical history/personal health records, consent and privacy forms, and the like.

I’d be interested to know from a marketing perspective, whether patient-facing educational campaigns result in an increase in new patients who are attracted to more technically advanced facilities, and if these same patients experience better clinical outcomes and satisfaction as a direct result of new HIT systems. If you hear of anything, let me know.

Watching the Leaves Fall and EMRs Install in North Carolina

Posted on September 15, 2011 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

In celebration of National Health Information Technology Week –  proclaimed by President Obama earlier this week in an effort to “urge all Americans to learn more about the benefits of Health IT by visiting HealthIT.gov, take action to increase adoption and meaningful use of Health IT, and utilize the information Health IT provides to improve the quality, safety, and cost effectiveness of health care in the United States – I’m hitting the road and heading to North Carolina.

Actually, it’s pure coincidence that my annual Fall road trip to Charlotte and Chapel Hill coincides with this newly official week of celebratory activities. (You can view a list of events here.) But it did prompt me to ponder the state of North Carolina’s EMR and overall healthcare IT utilization. My first stop was the HIMSS State HIT Dashboard, a handy resource that provides an overview of all 50 states’ utilization of healthcare IT.

According to HIMSS, as of September, 2011, North Carolina has six Health Information Exchanges (HIEs):

  •  NC Healthcare Information and Communications Alliance Inc. (NCHICA)
  •  Carolina HIE
  •  Coastal Connect
  •  Western NC Health Network (WNCHN Data Link)
  •  Southern Piedmont Partnership for Public Health (SoPHIE)
  •  Sandhills Community Care Network

The state’s regional extension center, which assists the state’s physicians with selecting and implementing EMRs, has at this point recruited 50% of the providers in its target group of 3,500 priority primary care providers, according to the NCHICA website. The NCHICA seems to be the main governing/advisory body over the state’s HIT activities. Its 239 member organizations will converge in just over a week at the Grove Park Inn in Asheville for its annual conference and exhibit. The lineup of sessions looks pretty interesting, especially “So You’ve Decided to Implement an EHR, Now What?” I’m sure conference attendees will have a great time at the Brews Cruise as well.

My next stop was Google, where a quick search yielded the fact that North Carolina, and the Duke Center for Health Informatics in particular, is home to MindLinc, an EMR for behavioral health. It is now the world’s largest codified behavioral health database, and provides information for research and benchmarking purposes.

My last stop was YouTube, where I found an interesting video created by Janet Apter, an RN and member of the faculty at the Duke School of Nursing, for Duke’s Doctor of Nursing Practice Program. Entitled “Electronic Health Record – a Promising Solution,” the video shares the perspective of one nurse/patient’s frustration with a lack of interoperability between facilities in the same health system, and makes a simple case for the need for a nationwide EHR system.

Is This Failure Really Necessary? Another HIE Closes Its Doors

Posted on July 22, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

For several years, I’ve been watching health information exchanges struggle to birth themselves. Despite ongoing support from state and local governments, HIEs continue to fade away, few having found a business model that works. And no workable business model seems to be on the horizon yet, either, despite efforts by thousands of providers to keep their HIE afloat.

This week, I was sorry to read about the death of yet another HIE.  CareSpark, a Kingsport, TN-based network which has been in existence for six years, announced on July 11th that it would be ceasing operations.  CareSpark, whose age makes it almost a young adult in HIE years, holds records for 1.28 million patients.

According to a piece in FierceHealthIT, CareSpark was forced to close because it couldn’t come up with a viable plan to sustain itself.  The group’s leaders had hoped to move from a grant-supported non-profit to one-funded by payments from subscribers, but apparently, they just couldn’t attract enough cash to survive.

The group began its final descent in March, when Health Information Partnership of Tennessee pulled federal funding from CareSpark.  The closing leaves 38 participating healthcare organizations in the lurch.

Given you don’t have a mature EMR if you can share health information freely — at least according to HIMSS Analytics — you’d think that providers would finally be ready to dish out enough money to support their local HIE.  But apparently, they aren’t.

The question is, why?  Do hospitals and medical practices think of HIEs as “nice to have” rather than “need to have”?  Do providers only kick in money when they can control the whole exchange (such as linking up hospitals within a single chain)? Have any of them done a cost/benefit analysis which suggests HIEs *aren’t* a good investment?

All I know is that if 38 providers spend six years building up trust, it doesn’t make much sense to cheap out now, especially if it shuts down critical linkages between their EMRs. I’d really like to know why they don’t want to pay for this. Don’t you? After all, it’s about time we figure out what kind of HIE model does work.

Mayo Developing Tools To Extract Medical Data From All EMRs

Posted on July 17, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Here’s some interesting and potentially important news. According to some recent news items, it seems that Mayo Clinic investigators are putting the finishing touches on a suite of tools which can identify and sort medical data contained in any electronic medical record.

Mayo investigators are working under a federal grant, the $60 million Strategic Health IT Advanced Research Projects (SHARP) program, which is funded by the ONC.

According to a piece in Government HealthIT, the researchers have used natural language processing tools to isolate health data from about 30 digital medical records of patients with diabetes.  So far, so good. When the extracted data is run through specialized systems developed with IBM’s Watson Research Center, the 30 patient records “explode” into 134 *bilion* individual pieces of information, Government HealthIT reports.

Unfortunately, none of the sources I have explain what specific data pieces make up this total, which sounds extremely high to me. If we’re talking about just 30 patients, it’s hard for me to imagine that mundane details of care represent even multiple thousands of data points, unless you’re dealing with decades of care. (Perhaps the information involved includes the coding needed to extract the data — readers, can you clarify this for me perhaps?)

While I can’t testify as to how realistic the Mayo researchers’ claims are, I have to think that if they’re on target, something very big is in the works.  After all, to date I’ve heard little of tools that can effectively, fluidly extract clinical data from an entire EMR-based patient chart regardless of format or data organization. Concepts like natural language processing are far from new, but it seems they haven’t been up to the job.

Not only would  such capabilities allow virtually any set of institutions to share data, a giant leap in and of itself, they would also allow providers to do unprecedented levels of clinical analysis and ultimately improve care.

On the other hand, it’s not clear how practical this approach will be. If it only takes 30 records to generate that much data, just imagine how much data a single mid-sized hospital would have to wrangle!  If I’m reading things right, this technology may remain stuck at the research stage, as it’s hard to imagine most institutions could manage terabytes of new data.

Still, there’s clearly much to learn here. I’m eager to find out whether Mayo’s SHARP technology turns out to be usable in everyday clinical life.

 

 

Hospitals Slow To Convert Paper Records, And May Not Know How To Manage Them

Posted on July 13, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Anyone who’s been around the HIT block a few times knows that the conversion from paper to digital records is going to be much uglier than the public thinks.  This new study from vendor Iron Mountain, however, offers some details that surprised even a cynic like myself.

The study, which surveyed 200 health information pros, asked them how they were doing with scanning paper medical records and how they expected to use the paper archives in the future.

One of the most interesting findings from the study, in my  view at least, is that while 70 percent of hospitals are claiming Meaningful Use Stage One rewards, 78 percent expect to use paper records for as many as five years more.

The study also found that hospitals planned to spend as much as $100 million just on the scanning process, a number which rocked me a bit even given the size of the  problem.  Iron Mountain researchers concluded that the costs are running high, in part, because institutions are using many different approaches to digitizing medical information.

Other data points from the study:

* About half of hospitals said they’d scanned what they needed to scan and were within budget

* Twenty-three percent of hospitals  said they were within budget for scanning, but had a backlog of records left to scan

* Once they scan their paper records, 58 percent of hospitals plan to shred  them, while 38 percent will store legacy records in an onsite room or offsite facility.

* Fourty-four percent of hospitals “are not explicitly measuring the effectiveness or productivity of their scanning process,” researchers concluded.

Though it’s interesting on its face, the study summary raises lots of questions.

For one thing, what metrics are 56 percent of hospitals are using to measure scanning effectiveness? Are we talking about accuracy of OCR performance, employee time invested, speed of scans, ease of retrieving stored data, or other measures?

How are hospitals with active EHRs keeping track of which documents have been scanned, which haven’t, which have been pulled and are in queue to be scanned and which have been reviewed for quality?

How will the 38 percent of hospitals planning to store paper records going to manage those paper records? Will staff have the ability to access paper records in a timely way if they need them?

I have no doubt that decent IT solutions exist to handle these issues. In fact, given that the banking business still exists, we know that one can move an industry from paper to digital records without a complete collapse. But as both an analyst and a patient, I wish I felt more confident that this particular transition is going smoothly.

The Joys Of A Digital Emergency Department

Posted on June 3, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Folks, tonight I was reminded of why supporters get stars in their eyes when they talk about how health IT can change the business. OK, maybe that’s a bit of an exaggeration, but it was lovely to see a group of medical professionals using and perhaps even enjoying their EMR rather than finding it a burden.

I was visiting the emergency room of a hospital in my area with a family member, who was unfortunately having some symptoms I felt needed immediate attention. The family member, my spouse, was too groggy to share many details of his prior care.

Enter the hospital’s EMR. Since my spouse had been seen there before, the staff was able to pull up a history, medication list,  allergies, test information and more. (Another sweet aspect for the hospital was that our billing information and insurance data were already available as well.)

After triage, the nurse was able to set the caregiving wheels in motion effortlessly, from her desk. His room assignment, status and designated caregivers were instantly pushed to a huge screen hung in the center of the nurses’ station.

From that point on, most of the visit was standard, but it was hard to miss that virtually everyone seemed happy and comfortable with the software, and that virtually none of the process produced paper documentation.  Not too surprisingly, the 50-something doctor who saw Mr. R took pen-on-paper notes, but he was the exception.

My sense is that the hospital must have done an excellent job of training staff members, who were happily clicking away and seemingly, handling tasks far more quickly than they would with paper charts. Handoffs between nurses seemed to flow more quickly than I’ve seen elsewhere. Our doctor popped into my husband’s room within 5 minutes of his arrival, possibly due to luck but more likely due to efficient handling of patient flow by the administration.

So what? you may be thinking. Isn’t that what the technology is supposed to do? Well, yes, but it doesn’t work that way nearly often enough, as we all know.

My point is just that after having seen so many professionals struggling to make sense of their EMR — and hearing from countless others who fear the same result — it’s always good to see a smoothly-working implementation in place. I do get so tired of being a downer!

EMRs: The Question of the Lady or the Tiger

Posted on April 18, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Here’s a tale which, believe it or not, may be worth discussing on an EMR blog.

In a classic short story by Frank Stockton, published in 1882, readers are asked to make their guesses about human nature and the capacity for self-sabotage, jealousy and fear of the unknown.

As the story, “The Lady, Or The Tiger,” goes, a princess has taken a lover below her social class — and to punish her, the king submits both her and her lover to an ordeal. The lover must enter an arena and choose one of two doors, one with a woman behind it and another with a ferocious killer tiger poised inside to spring.  If he chooses the tiger, he’ll be killed; if he chooses the door where the woman waits, he must marry her.

The princess, as it happens, knows which door poses which threat. But she has a dilemma to face. She doesn’t want her lover dead, but she doesn’t like the idea of his marrying another woman, one whom she actually envies. The question Stockton poses, at the end of the story: “Will the tiger come out of that door, or the lady?”   Nobody knows, since Stockton doesn’t tell us, but it’s food for thought — as a parable for EMR adoption.

Am I crazy to draw such a comparison?  Actually, I don’t think so.

Right now, hospital and physician staff members essentially have their own choice to make — embrace EMRs or dig in their heels and make the transition last as long as possible and cost as much as possible.  Sure, individuals will have more nuanced reactions, but globally, I’d argue that an institution either embraces EMRs or fights them.

So, clinicians and support staffers basically have two doors to choose from, one which generates certain disruption, change and possibly the end of the jobs they know (the tiger). That’s embracing EMRs.  The other door (the lady) comes with requirements of its own but is arguably a much less painful choice.

Which door they choose, fortunately, isn’t completely up to chance.  If there’s a “princess” — OK, the analogy falls apart here, guys — to indicate which door works and give people the guts to open it, things will move more smoothly.  That “princess” leader (in reality, many leaders at many levels) will have to sell people on the value of disruption, change and ultimate benefit, rather than the “lady” door which seems so much less threatening.

But the story, which is more than a century old, reminds us that even the leaders may not be sure where they want to lead if both choices force them to change their lives.   Diminish anxiety, detooth the tiger, and your EMR install may move forward.  Allow people to get hung up on the illusion of having a choice, and you’re out of luck.

Who Are You Leaving Out Of Your EMR Plans?

Posted on April 11, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

As any reader of this blog knows, it takes a lot of consensus building to successfully implement an EMR, whether you’re rolling it out across a large health system or within a small medical practice.

The thing is, I get the sense that many of the day-to-day staffers who will have to live with the EMR system aren’t consulted during the acquisition process, or only at best, only get to participate late in the game.

I’ll remind readers up front that I’m a journalist, not an EMR consultant, but from what I’ve seen, the following healthcare professionals seldom get much input into EMR decision-making:

– Front-line nurses

– Nurse managers

– Billing managers

– Coding professionals

– Medical practice managers

– Day-to-day IT support staff

– Medical assistants

While admittedly, some of these players play a more central role in patient care than others, they all have a window into what the EMR should deliver.  And if you asked them to review the vendor demo, examine the features and pose some questions, they might find issues that you hadn’t anticipated.

They might also note process problems that you weren’t aware of which, even if they can’t be solved by the EMR itself, may never come up for discussion during the normal course of business.

All told, my sense is that if a hospital or medical practice circulated questionnaires asking a broad range of staffers what the EMR should do, and what’s not working in the current environment, they’d make better decisions and learn a lot about their organizations along the way.

Unfortunately, I doubt this will happen much, as healthcare is still lamentably hierarchical and riddled with inefficient top-down decision making. But hey, the idea’s worth a mention…