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Beyond Implementation: A Prescription for Lasting EMR Adoption
Despite the significant benefits of electronic medical records, organizations continue to struggle with successful technology adoption. Beyond Implementation examines the primary reason for poor and failed EMR adoption, explores real-world results from large healthcare organizations, and reveals a new approach for successful adoption and lasting value. The authors, Dr. Heather Haugen and Dr. Jeffrey Woodside, have witnessed the outcomes of poor adoption and are committed to helping organizations successfully adopt an EMR system. Through actual case studies and research, the book investigates the barriers that keep physicians from making EMR part of their routines. The key a myopic focus on go-live implementation impedes the adoption and long-term sustainment of EMR.
140 pages, Kindle Edition
First published May 1, 2010
7 people want to read
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Displaying 1 - 2 of 2 reviews
January 13, 2011
I thought this book was a decent introduction to EMR concepts, but was very light on details.
April 3, 2017
I received a complimentary copy of this book in exchange for an honest review.
Although I'm and interested observer and not a health care professional, and therefore not the target audience of this book, I found it interesting as a person who designs and builds new software solutions, and as a patient.
The key message is that "adoption" is not the same as "implementation" of health care technology. I hadn't realized that only 12 percent of non-federal acute care hospitals and 48% of private practices had installed EHR's in 2009. My family gets its care almost exclusively at an academic medical center, so EHR's have been the norm for me for over a decade.
This book is an update to an earlier study of factors that drive successful EHR adoption. Clearly the emphasis in the earlier book had been on the effort necessary to go live with an the EHR. In this book, the authors convey the message that implementation is an ongoing process that requires continuing investments of effort.
Having participated in several failed implementations of enterprise software solutions, that message certainly rang true for me. I appreciated their emphasis on the importance of leadership maintaining focus on implementation and "developing a ferocious understanding of what they are going to stop doing, and then maintain[ing] the courage to follow through on their decisions." _Good to Great_ first pointed out the importance of deciding what to stop doing, but it seems we can never hear it often enough, because the lesson is so seldom applied.
The first chapter outlines Health South's model for a scalable, repeatable process of adoption/implementation across a number of sites. Key takeaways were the importance of cross-functional teams for implementation, the necessity of having leadership come from the business/medicine side and not the IT side, and the critical importance of hands-on/simulation-based training in the specific tasks key to a person's role, rather than broader lecture-style training.
In the section on the importance of effective end-user training, I found myself frequently underlining and highlighting -- it's shocking how little of what we know about how people learn gets translated into practice. As I was reading this chapter, I kept thinking of the uniform-designer character in _The Incredibles_, who constantly repeats, "No capes!" In this case, she would be shouting, "No classrooms!"
One sentence struck me as worthy of being engraved above the doors of all leaders charged with adoption of such solutions: "Quick fixes such as blaming providers, vendors, or leaders, purchasing a new or upgraded application, forcing user compliance and ignoring poor outcomes also bring unintended consequences that actually cause a negative reinforcing feedback process, further delaying the solution of the problem." (44).
The point that "most organizations grossly underestimate the effort and resources required to sustain IT adoption" seems true across industries -- as does the importance of tracking metrics.
I could have done without the frequent tired old business-speak metaphors and mis-attributed quotes (the "breakaway" metaphor is particularly painful, as is the attribution of the "definition of insanity" quote to Ben Franklin, which a ten-second Google search revealed is unlikely), but those sins certainly aren't unique to this book.
After reading a book like this, I am always left wondering how best to implement what it contains. I can imagine very few senior leaders will say to themselves after reading it, "Gosh, I've certainly been under-resourcing this effort and need to figure out what we should stop doing," or "goodnesss, we need to revamp our training program." But maybe they will.
Although I'm and interested observer and not a health care professional, and therefore not the target audience of this book, I found it interesting as a person who designs and builds new software solutions, and as a patient.
The key message is that "adoption" is not the same as "implementation" of health care technology. I hadn't realized that only 12 percent of non-federal acute care hospitals and 48% of private practices had installed EHR's in 2009. My family gets its care almost exclusively at an academic medical center, so EHR's have been the norm for me for over a decade.
This book is an update to an earlier study of factors that drive successful EHR adoption. Clearly the emphasis in the earlier book had been on the effort necessary to go live with an the EHR. In this book, the authors convey the message that implementation is an ongoing process that requires continuing investments of effort.
Having participated in several failed implementations of enterprise software solutions, that message certainly rang true for me. I appreciated their emphasis on the importance of leadership maintaining focus on implementation and "developing a ferocious understanding of what they are going to stop doing, and then maintain[ing] the courage to follow through on their decisions." _Good to Great_ first pointed out the importance of deciding what to stop doing, but it seems we can never hear it often enough, because the lesson is so seldom applied.
The first chapter outlines Health South's model for a scalable, repeatable process of adoption/implementation across a number of sites. Key takeaways were the importance of cross-functional teams for implementation, the necessity of having leadership come from the business/medicine side and not the IT side, and the critical importance of hands-on/simulation-based training in the specific tasks key to a person's role, rather than broader lecture-style training.
In the section on the importance of effective end-user training, I found myself frequently underlining and highlighting -- it's shocking how little of what we know about how people learn gets translated into practice. As I was reading this chapter, I kept thinking of the uniform-designer character in _The Incredibles_, who constantly repeats, "No capes!" In this case, she would be shouting, "No classrooms!"
One sentence struck me as worthy of being engraved above the doors of all leaders charged with adoption of such solutions: "Quick fixes such as blaming providers, vendors, or leaders, purchasing a new or upgraded application, forcing user compliance and ignoring poor outcomes also bring unintended consequences that actually cause a negative reinforcing feedback process, further delaying the solution of the problem." (44).
The point that "most organizations grossly underestimate the effort and resources required to sustain IT adoption" seems true across industries -- as does the importance of tracking metrics.
I could have done without the frequent tired old business-speak metaphors and mis-attributed quotes (the "breakaway" metaphor is particularly painful, as is the attribution of the "definition of insanity" quote to Ben Franklin, which a ten-second Google search revealed is unlikely), but those sins certainly aren't unique to this book.
After reading a book like this, I am always left wondering how best to implement what it contains. I can imagine very few senior leaders will say to themselves after reading it, "Gosh, I've certainly been under-resourcing this effort and need to figure out what we should stop doing," or "goodnesss, we need to revamp our training program." But maybe they will.
Displaying 1 - 2 of 2 reviews