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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

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.

Who Will Police EMRs and EHRs?

Posted on 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.

Amid all the dog-bites-man type health IT news, here are some not-so-positive EMR/EHR stories that have been reported:

– An EMR in Lifespan hospital group gave incorrect prescriptions to some 2000 patients. The article in the Providence Journal says that

The hospitals have placed calls to nearly all the affected patients, although not all have called back, Cooper said. Most patients reached had already obtained the correct medication because the error was noticed by someone at the hospital, or a pharmacist or doctor outside, she said. So far, Cooper said, there is no evidence that any- one was harmed.

Thank goodness for that.

– Incorrectly calculated MU thresholds (GE Centricity). I’m not going to rehash the story, but you can check out Neil Versel’s article in InformationWeek, the spirited discussion on my previous EMR and EHR blog post and John’s EMR and HIPAA blog post.

It might be just be my skewed viewpoint, but GE Centricity related issues are nowhere on par with people being prescribed the wrong prescription. In one case, a few practices may not be able to demonstrate Meaningful Use. Wrong medication could actually be life-threatening to you. So if I had to rank my problems, I’d rather be short by 44K than worry about my EMR inadvertently killing my patients off.

What we need is a governing body, similar to the National Transportation Safety Board, to police EMRs, says Paul Cerrato in a recent InformationWeek Healthcare article.

Cerrato writes:

“An NTSB-like organization for EHRs would at the very least provide a reporting mechanism to keep track of incidents and life-threatening consequences of misusing e-records. More importantly, it could police vendors and healthcare providers who repeatedly ignore these dangers.”

Cerrato goes on to say there are only 120 EHR-specific problems reported to the FDA over the last 18 years. That figure, if correct, to me shows:

  • EMR users don’t know how/where they can report EMR related errors or don’t expect any action to be taken – this certainly is credible, because from all quarters, it seems as if the focus is just to get the healthcare field into electronic data capture, not on whether the experience delivers any tangible and useful benefits
  • Maybe they’re willing to give EMRs a pass assuming the healthcare IT to be in infancy
  • They’re too overwhelmed with the EMRs’ capabilities/inabilities to really see what’s going on

For a national database of EMR problems to be truly relevant, here’s the information I would look for, on problems I’m facing:

  • How critical was the error? How many people did it affect, and in what ways – medically, financially?
  • How was it handled?
  • How common is it – are there others who’ve faced similar problems?
  • If the problem was not sorted, what raps on the fingers did the vendors face?

Read the article here.