What makes the Difference Between Success and Failure in an EMR Rollout?

What is the difference between success and failure?  Both ostensibly have the same set of goals. Both strive to improve the business as well as the clinical sides of health care. I have been involved in both spectacular failure  and enormous success. Over the next few posts, I want to start the conversation about the reasons why some fail and others succeed. I will use my experiences of failure and success to point up the issues.                                                                                                                                 

The first glaring difference between the success and failure was preparation (or lack of it). One of the Doctor/owners had a Doctor friend (already we see a looming, eye-rolling mountain of issues) who was involved in developing a new EMR system. For a mere $100K, we could get into a DOCTOR developed system. If a Doctor/friend (now ex-friend) was involved, it must be good, right? So, we all saluted smartly, handed over the money and jumped into the bottomless pit. No preparation. Just paint over the old rust and flaking paint in our systems and practices and get going.

It wasn’t long before it became obvious that the system had several glaring deficiencies.

Trying to interface it to anything was like introducing an aggressive dog to a defiant cat on an oiled floor. Data went everywhere but where it was aimed. It was as unreliable as a securities company business plan. It was not a follower of the laws of physics, being down more than up. And it got worse from there on.

The Health Care  business was not healthy — billing was at a stand-still, front desk collections were a guess  at best and ulcers were multiplying everywhere.  Going back to paper and some 24 hour work days brought us back into the game. A couple of months of very low pay to the Doctor/owners achieved a salutary effect.

Readers, it is not a good idea to pay for an unproven system, particularly if it is presented by a friend of the owner. As an older computer user, who remembers a day when the only computer was a slide rule, always remember this dictum: Lousy systems, when computerized, will still produce lousy results, just a lot faster. Next time, we will begin to talk about proper preparation and how to go about it.