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EHR Implementation projects from the last decade have been costly and time-consuming projects for most healthcare systems in the country. Making an implementation successful often requires a ‘get live, then optimize’ mentality. When the organization is ready to optimize, discussions about data management are typically top of the priority list.
I recently wrote about how I always try to follow the vendors’ recommendations when implementing healthcare information technology (HIT). I’ll summarize my thoughts in case you missed them: I want to work with vendors who know what they’re doing and have done similar work before. I expect those vendors to understand my business needs and wants, and have solid best practices about how best to achieve those needs and wants with their technology. I try to follow those recommendations unless I or my team can articulate operational or clinical reasons negating the vendor’s directions.
With New Year’s Day in our very recent past, I thought it appropriate to propose some resolutions for those of us in the healthcare IT trenches. These are in no particular order, and like all resolutions, I make no commitment to following any of them myself.
Medicine has been plagued by a culture of paternalism since . . . while, since forever. It’s still around, of course, but we’ve come a long way in the last few decades. I cringe when I watch movies from the 1940s and 1950s portraying a physician sharing private medical information with a woman’s husband because she couldn’t be trusted to understand complicated health information. Or maybe because she would react “hysterically” to a poor prognosis. While those sexist stereotypes are hopefully on their way out, I still see some physicians continue in less obvious, but still paternalistic, ways.
Installing software at a hospital can be like taking a road trip across the country with a caravan of cars. In one car, you have the IT department. In the other cars, you have the end users. The goal of the trip is the same for everyone - to arrive safely at the destination as quickly as possible.
I have to admit that doctors often confuse me. Now I know, if you’re a regular reader of mine, you might think that’s odd because . . . I am a doctor. Yet still, sometimes my colleagues do things that I cannot explain. Because I focus on the cross section between technology and medicine, you can reasonably predict that I’m not going to be writing about why doctors choose a foreign car versus a domestic one. Nope, I want to deal with doctors and their habit of mouse clicking when no mouse click is needed.
A topic at the forefront of many hospitals we work with is how to address the ever-growing problem of physician burnout. There are certainly many factors, however a primary one is the dissatisfaction with the electronic health record (EHR) and extra time spent outside of patient care completing documentation.
Let me recap my previous blog post: I made the argument that the customer (aka EHR user) doesn’t always know what she wants, and it’s up to the IT analyst to provide for the users’ needs. I also posited that standardization and EHR vendor alignment is often a good thing, and that sophisticated healthcare systems across the country are pulling out perfectly good build to replace it with recommended configuration from the company that produces the software. Some IT folks are understandably uncomfortable with these changes because they now see themselves as “the heavy” and must tell end users that they can’t always get what they want.
You may have been taught that the customer is always right, but it’s been well-established that the customer is most certainly not always right (see my posts here and here). Plenty of successful, innovative business owners point out the fact that often, the customer has no clue:
I’ve been thinking and reading a lot about curation recently. By curation I mean allowing experts to make decisions for those of us who are not experts. My first experience with curation happened four or five years ago. I walked into an optical store with my wife to look for some new frames. My vision is so poor that when I don’t have my prescription glasses on, I can’t really see much of anything at all. So, you can imagine how helpless I am when I take off my glasses to put on a pair of frames with no lenses. Sure, I can look at the mirror from an inch away and maybe have an opinion, but c’mon! That’s not very effective. Hence, I typically just put myself in the hands of my wife.