Many healthcare organisations are on the journey to digital disruption. Unfortunately, a lot of them will have a difficult time reaching it. Most organisations are just in the beginning stages, while some are still in the starting blocks. Additionally, there are many internal and external issues that may delay or stall the process. Here, we will discuss some of those ‘stumbling blocks’ and offer suggestions on how to overcome them.
The three continuum’s organisations need to address if it is going to digitally transform are data/technology, people/organisation and process/workflow. If they do, they will have a better chance of success than those addressing this as purely a data or technology issue. In spite of that, there are still some major stumbling blocks that will impact the organisation’s success. These will each be addressed by continuum.
This is the continuum that gets the most attention. Most organisations have installed an Electronic Health Record (EHR) system. For many, the EHR alone has become a stumbling block. There have been delays on the part of the organisation or the vendor that has cost millions of dollars in implementation costs and/or stimulus incentive money. Recently, articles have been published that discuss how Chief Information Officers (CIOs) have been terminated for buying a very popular EHR with a good reputation. Unfortunately, the real reason those CIOs were terminated was not that they choose this EHR solution but because they chose the wrong solution for their organisation and/or didn’t have the right resources to implement the solution, which led to extensive cost overruns.
To overcome this stumbling block, the organisation has to first make sure they use a proper selection process. Not every solution will work for every situation. Second, they have to make sure they have the right resources to implement the solution. This will mean making a hard assessment of the staff’s capabilities to implement and customise the solution and/or determine if staff augmentation needs to be included in the budget. Third, they have to make sure they use proper project management methodologies. Without this, the implementation could spin out of control resulting in missed deadlines and exceeded budgets.
An area that is out of the organisation’s control at this time is the lack of mainstream analytical tools. Most healthcare analytical tools are revenue cycle management focused, others are custom made or are being built into various EHR solutions. If your organisation does not have one of the solutions with built-in analytics or can’t afford custom analytics, you could miss out on the real benefits of being data-enabled with the needed real-time decision support tools.
This continuum deals with the workflow of how the data is captured and managed. The biggest stumbling block on this continuum is gaining accurate data capture throughout the healthcare organisation network. Some workflows may accurately capture data only some of the time when it needs to be accurately captured 100 per cent of the time. Capture rates can vary by unit, hospital unit or hospital network. Some of this is addressed by the ‘People’ continuum stumbling block to follow.
This stumbling block is primarily overcome by utilising the best workflow for your organisation. When a software solution is purchased, some will follow your current workflow, some will force a workflow change to fit the solution, while the best will be flexible enough to incorporate your workflows into the industry best practices to maximise efficiencies.
Although the resistance to using an EHR by many in the provider community has declined, some have found many ways to keep from having to use the technology, including continuing to make verbal or telephone orders for the nurses to enter. To overcome this stumbling block, the organisation has to help the providers embrace the change. This is difficult because we are making a change to an entire industry in a short amount of time. Telling them to embrace change is easy to say but difficult for most people to do.
To overcome this stumbling block, the organisation has to manage the physician staff’s expectations. Physicians should be included in the EHR decision making and implementation planning process. The organisation should also identify champions who naturally embrace the change and who will help drive the implementation amongst their peers. When an organisation’s physician champion hears a colleague, who is not completely on board complaining about the solution, they could help by providing positive and/or correct information. Lastly, make the physicians part of the ongoing process through recognition for usage and allowable incentives, for instance, tracking and reporting on the top users of the solution.
To implement these strategies is straightforward but requires a special skill set to manage. You need a good strategist, technologist, project manager, human behaviour specialist and communicator all in one.
First, you will need to perform or have someone perform an assessment of where your organisation is on each continuum. There is more to the continuums than has been covered here. Next, you will need to put a plan in place to advance your organisation along the continuums recognising the fact that there will be stumbling blocks that will need to be addressed. Lastly, follow your implementation plan looking forward to where you need to be while looking back at where you’ve been with an honest assessment of your capabilities and success.
Digital transformation is a journey. Treat it as such and you’ll have a successful and adaptable implementation.