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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.

Who Moved My Cheese (or Paper Charts)?

Posted on April 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 got just a glimpse yesterday of what clinicians must feel like when they log into an EMR for the first time – giddy with anticipation, hopeful that its use will ultimately lead to better patient outcomes and easier workflows for all. On the flipside, there was also frustration, impatience, and a bit of confusion.

Just before bedtime, I fired up Calorie Counter, my newest iPad app. As with any community you join, I first had to fill out a member profile, which took some time. I then had to learn through trial and error how to navigate through the program – search for, find and choose the foods I had eaten earlier that day, make adjustments for portion sizes, then log the data. The app’s drop-down menus included some of the foods I ate, but not all. “How do I add foods to the stock menu?” I wondered, thinking at the same time that this must be what doctors feel like when they can’t find what they need in an EMR.

It didn’t take long, and I’m sure now that I’ve at least done it once, future data entry will be more intuitive, and quicker. I do wonder about the rate of retention for this type of app, though. Do people stick with it for more than a few days or weeks?

I’ll have to either keep a running paper list of the foods I eat throughout the day, or bring my iPad with me wherever I go in order to log my calories. I was bummed that I couldn’t find this particular app for both the iPad and iPhone. (Those that were developed for both just didn’t seem to be as robust.) Perhaps this twinge of disappointment has been felt by doctors who have fallen in love with their new EMR, only to realize they can’t access it via their chosen mobile device.

It will take dedication on my part to keep up with daily logging of calories and activity, but I am convinced it will be worth it. After just one day, I’ve already had a nutritional wake-up call: Just seeing how much cheese I eat has made me decide to cut back before bathing-suit weather.

The beauty of the app isn’t the comprehensive list of foods already plugged in from which to choose from, but the calorie recommendations it makes based on members’ profiles (weight/height/activity level/age/gender, etc.) and the analytics that will result after I have a few days/weeks/months logged. Patterns will emerge that will give me a clearer picture of my diet – foods I should keep eating, those I should eat in moderation, and those I should avoid all together as long as I’m trying to reach a certain daily caloric intake. Not quite as important, but still similar in my mind to the aggregating power EMRs have when it comes to clinical data.

Other than keeping up with the daily log, I also have the option of joining the Calorie Counter community on Facebook, and I think there’s a brief tutorial out there I can take a look at. Depending on my time available, I may not do either – a course of action I’m sure a few doctors also opt to take with their EMRs, which I assume is ultimately detrimental to the results they’ll see with the technology.

In addition to trying to get a bit healthier, I’m overcoming my resistance to change (as if I really want to eat less cheese!), which as my colleague John pointed out in a recent post at EMRandHIPAA.com, is “the number one reason doctors aren’t adopting EHR software.”

But change is usually good, and as John also points out, “resistance to change is going to be the reason why EHR adoption will become the norm.” I’ll let you click over to his post to find out why. In the meantime, I’m going to try and resist the bagel with cream cheese that seems to be calling my name from the kitchen.