For electronic health records (EHR) implementation, learn from ERP, CRM rollouts

Think health care is unique? Two Ovum analysts argue that lessons learned from enterprise resource planning and customer relationship management can work for EHR implementation, too.

There's no question that an electronic health records (EHR) implementation poses unique challenges to health care CIOs, among them the noninteroperable data sets that reside on networks in multiple buildings on sometimes multiple hospital campuses.

Two Ovum Research analysts, however, argue that other industries had to overcome similar problems when they rolled out enterprise resource planning (ERP), customer relationship management (CRM) and enterprise content management (ECM) applications.

With dollars from the HITECH Act at stake and a staggering economy squeezing health care IT budgets, applying the lessons learned in other industries could help health care providers avoid costly electronic health records implementation mistakes, according to a new Ovum report, "Electronic health records: Getting it right the first time."

"If you think about the dynamics of this, when you talk electronic health records and especially meaningful use, you're not going to confine [an EHR system] to just one department, such as radiology," said Ovum analyst Tony Baer, who co-authored the report with colleague Christine Chang. "If you're going to attain meaningful use, you're going to have to go organization-wide. Compar[ing] that to ERP and CRM, the parallels just hit me between the eyes."

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There are plenty of best practices from ERP and CRM from the last two decades that apply to EHR implementation, according to Baer, Chang and their report. Some of the key points highlighted include the following:

Get the economics right. The prospect of financial incentives could skew the cost-benefit analyses that providers conduct for electronic health records implementation projects. Don't try to shoehorn project costs into the amount of incentive money for which you are eligible, underestimate costs because of incentive payments, or take on the project just because you are getting a grant.

Get buy-in at every level. Like all enterprise-wide IT projects, it's essential to marshal support, all the way from the C-level managers, who need an effective value proposition, down to the frontline caregivers, who will be using the EHR system many hours a day and therefore need to be deeply involved in the planning process. Without buy-in, the system won't be used enough to create meaningful use compliance, reap incentives and avoid penalties.

It's mostly change management that it really comes down to. The technology is there, it's just a matter of how you implement it.
Christine Changhealth care analyst, Ovum Research

Establish workflow. In a similar vein, customizing an EHR workflow for your organization and touting it to frontline caregivers is a starring role tailor-made for the chief medical officer. If your hospital doesn't have a CMO or chief medical information officer, find a physician champion to promote buy-in and provide feedback to the IT department on the ways electronic health records software affects workflow during patient encounters, as well as the types of problems it causes and their solutions. Find champions in other departments -- nursing, respiratory therapy, pharmacy, back office and so on -- who can play similar roles among their colleagues. Act on the feedback they provide.

Scope the project. Defining the requirements and controlling how they change as the EHR implementation progresses help maintain a realistic budget, schedule and set of expectations. It is also advisable to stage the rollout -- that is, to start with one department, catalog and fix mistakes, apply those lessons, and avoid the same pitfalls in the next department. This keeps the implementation on track while minimizing disruptions.

Stay focused. The key issues in ERP and CRM system rollouts -- architecture, terminology and managing goals in a highly changeable environment -- are equally key in the EHR implementation process. Above all, hone in on the people as much as you do on the technology -- if not more.

"It's mostly change management that it really comes down to," Chang said. "The technology is there, it's just a matter of how you implement it -- and those issues are human factors [that] are the same regardless of [industry]."

Let us know what you think about the story; email Don Fluckinger, Features Writer.

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