Implementation Insights Blog

Implementation Management Associates help organizations around the world achieve large-scale, complex change. This blog discusses our insights into organizational change.

Friday, March 27, 2009

Prescription for Electronic Medical Records Implementation Success

According to a recent New York Times article, the Obama Administration expects to spend about 19 billion dollars to accelerate the use of computerized records by Health Care systems and doctors offices. In the same article, Dr. Blackford Middleton, Chairman for the Center for Technology Leadership states, “What is underappreciated is the implementation challenge.”

These electronic medical records are the basis for both the diagnostic and economic lifeblood of any medical care practice, so getting the implementation right the first time is essential. Notes Dr. Patricia Korber, MD, "In my own practice, we thought we were ready, but we underestimated the degree of difficulty we were going to face.”

Unfortunately getting the technology “installed”, meaning that it is up and running, is not synonymous with gaining sustained adoption, or “implementation.” The
difference between installation and implementation is not mere semantics; it is a quantitative and qualitative difference that reflects the speed and return for the human and financial resources that will be invested in electronic medical records or EMR. EMR implementation speed is critical to health care providers both financially and because of the disruption to work flow and efficiency that directly impacts the quality of patient care.

Interestingly, the Obama Administration has set forth, but not yet defined, its term of “meaningful use” of Electronic Medical Records (EMR) as a criterion for subsidized payment for implementation in Doctors’ offices.

Based upon our thirty years of field research at IMA, over 70% of technology system implementations in Healthcare Systems (such as EMR implementations) fail to achieve on time and on budget what they promised to their organizations. In over 85% of the cases we have observed, technological integrity is not the issue. Ultimately, the technology will do what it is supposed to do. The stumbling block is in how to integrate the human beings with the technology as quickly as possible.

This literally becomes like those old Fram oil filter commercials: “You can pay me now or pay me later.” Any medical practice or health care system can either spend time to create readiness, or Prepay a substantial price for resistance to change and sub-optimized systems. After implementing technical systems in health care environments for two decades, we have yet to discover a situation where the third “no payment required” option came into play.

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