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EHR Lifecycle

Posted on May 30, 2017 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.

Far too many organizations look at the EHR go live as the end all be all to EHR implementations. Unfortunately, this fallacy in thinking has caused many EHR implementations to suffer after the EHR go live. The reality of an EHR implementation is that it’s never done.

This was highlighted really well in this graphic that The Advisory Board Company put out about the EHR life cycle. They compare the EHR lifecycle to that of raising a child. The most poignant part of this chart to me are the final 3 phases of the EHR lifecycle which are all after the EHR go live event. These final 3 phases are listed as ongoing. In other words, these final 3 phases will never end.

See the details in the graphic below (click on it to see a larger version):

If you don’t have a process in place to improve your EHR use, performance, and the benefits you receive from your EHR, then you should get one now.

Denmark’s Health System Suffering Familiar EMR Woes

Posted on February 21, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

If you’re trying to navigate the US healthcare system – or worse, trying to pay for your care — Denmark’s alternative may sound pretty sweet. The Danish health system, which is funded through income taxes, offers free care to all Danish residents and EU citizens, as well as free emergency treatment to visitors from all other countries. And the Danes manage to deliver high-quality healthcare while keeping costs at 10.5% of its GDP (as opposed the US, which spends nearly 18% of the GDP on healthcare).

That being said, when it comes to health IT, Denmark is going through some struggles which should be familiar to us all. Starting in 2014, the Danish government began modernizing its healthcare system, an effort which includes developing both new hospitals and a modern health IT infrastructure. One of the linchpins of its efforts is a focus on directing care to fewer, more specialized hospitals – cutting beds by 20% and hopefully reducing average lengths of hospital stays from five to three days – supported by its HIT expansion.

You probably won’t be surprised to learn, meanwhile, that Epic has inserted itself into this effort, winning a $1B project to put its systems in place across 20 hospitals with 44,000 concurrent users. Unfortunately for the Danes, who are starting with a few hospitals in one of the country’s five regions, the effort has run into some early snags. Apparently, the Epic installs at these initial test hospitals aren’t going according to plan.

According to one publication, initial hospital go-lives in May and June of last year have seen  major problems, including errors that have put patients at risk, as well as creating erroneous test reports, results and prescriptions. The Epic systems were also having trouble communicating with the Danish health card, which stores patient information on a magnetic stripe.

The questionable rollout has since caused some controversy. As of August 2016, the local doctors’ union was demanding that a planned deployment in Copenhagen, at Denmark’s busiest hospital, be put off until authorities had figured out what was going wrong at the other two.

At first, I was surprised to hear about about Denmark’s IT woes, as I’d blithely assumed that a government-run health system would have a “central planning” advantage in EMR implementations. But as it turns out, that’s clearly not the case. It seems some frustrations are universal.

I got some insight into this yesterday, when I took a call from an earnest Danish journalist who was trying to understand what the heck was going on with Epic. “Things are going badly here,” she said. “There are lots of complaints from the first two hospitals. And the systems can’t talk to each other.”

I told her not to be surprised by all of this, given how complex Epic rollouts can be. I also warned that given the high cost of Epic software and support, it would not be astonishing if the project ended up over budget. I then predicted that without pulling Epic-trained (and perhaps Epic certified) experts into the project, things might get worse before they get better. “Just hire a boatload of American Epic consultants and you’ll be fine,” I told her, perhaps a bit insensitively. “Maybe.”

When I said that, she was clearly taken aback. Even from thousands of miles away, I could tell she was unhappy. “I was hoping you had a solution,” she finally said. “I wish,” I replied. And I had to laugh so I wouldn’t cry.

Life After EMR Implementation

Posted on November 7, 2011 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

I spent a lifetime as an IT developer before I landed my present gig as technical writer in a health IT company. I can tell you from experience, that for many development teams, the implementation date is the biggie that the developers are racing against. And yet, the real fun often starts post-implementation. It’s not that different even with EMR implementation, you’ll be happy to know, at least according to this article at CMIO.net

According to the story, here’s what happened at Hospital Sisters Health System in Wisconsin and Illinois: A couple of months after their CPOE (Computerized Physician Order Entry) and EHR went live, the CIO received a letter with listing 38 issues faced by physicians using the EMR, with an ultimatum that these problems be fixed within two weeks. Half were known issues, and another quarter were training related. But even so, “The installation team was taken aback by the letter, including the physician champion.”

Now, not every IT project is like the one described but here are some lessons worth repeating from the Hospital Sisters example:

  • Prepare, prepare, prepare: That there will be unexpected issues is a given. The problem is not that issues crop up. How prepared you are – knowing how, when, who will handle glitches – is the difference between success and failure.
  • Train Your Users: I honestly get turned off when someone utters “It’s self-explanatory, really,” when it’s related to a software product. Yes, it might be, to you, tech geek, but not everyone was born with the chip embedded in their being. Expect to spend some time training your end users. Well-structured training sessions not only impart the know-how but can also be crucial rapport-building occasions with your buyers.
  • Support Your Users: After the initial euphoria of product launch, using your product might actually bring down the productivity some as users get used to using your product on a regular basis.