CHALLENGES OF IMPLEMENTING

EHR IN A PRIVATE HOSPITAL

J. DON M. SORIANO, MD MBA

What makes this difficult?

“Change is not the problem -

but resistance to change can be a huge problem.”

Torben Rick

Who wants to make the change? Does it matter?

Any top down decision, an imposed change, is more difficult to implement. People below feel excluded, yet they are directly affected. Innovation is best done as part of a participative process.

For IT projects, one size

does not fit all. Customize!

Understand the current process - the clinical and workflow process and support it with the new. Make small, progressive changes instead of one big sweep.

Understand what the change to EHR was for: !

Is it to improve process flow? Is it for data mining and research? Is it for patient record keeping? Is it for improvement of patient services? Is it for better clinical outcomes? Is it for optimization of business functions?

Define what is needed from the system so you know what results to expect. !Develop with end-use and end-user in mind.

What do I do when doctors and nurses are dissatisfied with the system?

Address design-reality gaps at time of conception. Make sure it works for clinicians. If it does not meet the needs of clinicians, it will fail.

“Expectations management is the key to successful projects. The

difference is the focus on managing the customer, rather

than the product or development team.”

Jeff Gainer

Explain the benefits. But in the end, you can’t please everyone. !

Who makes the decisions?

Influence the influencers & decision makers.

You can’t be the lone wolf.

Know where your system fits into the national system structure. Know the standards and interoperability.

What system should I use? Best of breed or Enterprise?

ReferencesElectronic Health Records, Manual for Developing Countries, World Health Organization

Health Information Systems: Failure, success and improvisation, Richard Heeks

Beyond Change Management, Linda Ackerson

Electronic Health Records for Public Health, Gordon Cressman

Making IT Happen: Strategies for Implementing the EMR - EHR, Health Information and Management Systems Society