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Terry McLeod of ehrSIO ProjectsehrSIO Projects
A blog about the technical and software sides of mental health and addictions

Joint Efforts

Terry McLeod Updated: Sep 13th 2011

More often than not, joint EHR implementation efforts have failed.

business meetingThese days, I'm hearing of more successful Electronic Health Record (EHR) purchase and implementation efforts that include several Mental Health agencies. This is a good thing for professionals and consumers on a variety of levels, not the least of which is accurate recording of treatment history, which paints a picture that may guide both professionals and consumers to more successful treatment and a happier life for the consumer. The success is significant because several vendors have attempted to make a big splash by selling a single software implementation to multiple agencies in a geographic area, but it seldom goes anywhere.

Why is that?

I read an article in Behavioral Healthcare Magazine that tackles this subject, and I can expand on their take.

Lynn Duby, CEO of Crisis and Counseling Centers in Augusta, Maine shared that the five agencies joining together for a software purchase had "strong ties". That's tough to develop among competitors, and if there's no unity, success will be limited. In the past, once a mental health or addiction treatment agency made the decision to buy a certain system from a certain vendor, the implementation often did not go well. The major reason for that is that the customer and vendor were simply not on the same page. When an agency buys an EHR, there are a lot of considerations beside price and whatever the driving force is to buy it now…what about the consumer? If professionals are stumbling through the software's workflow to find the documents they need to make a point in a session, perform an assessment, or collaborate with the consumer on the treatment plan, the consumer is just sitting there, feeling they are wasting time, or worse, living in their disorder. That's no fun for anybody, and is bad for business. The solution is to purchase software that works for all the parties involved, and the way to do that is to approach the purchase with a plan that's been successful elsewhere.

The banding together of five agencies to collaborate on an EHR suddenly becomes much more complicated because they work differently. Sure, the state and federal requirements are the same, but the way professionals work differs from agency to agency...that's what helps give agencies a personality the consumer can feel when they walk in the door. Duby's comment about "strong ties" tells us that the software must be flexible enough to suit all five agencies' workflows for all departments, and the professionals need to be flexible, too, in order to use common electronic documents and make the software affordable...Developing five different treatment plans is pretty expensive compared to making a couple minor adjustments on both the software and professional levels. The professionals who were less-than-enthusiastic about new EHR software either took an active role in the software selection, or developed a very Zen attitude: It is what it is.

It seems to be a fact that decision-making by committee is slower than when a single, strong leader is in the picture. When a number of professionals with different ways of working collaborate on an EHR, the committee becomes the decision-making method. I prefer working with a strong leader (or being one), and there are a lot of strong personalities involved in the management-by-committee scenario. Oftentimes, some of these personalities are at odds with one another and managing conflict becomes a major part of the process. I think it's a great success when an EHR selection can be made in less than a year. Most either take longer or fizzle out entirely (just to give you an idea, it ought to take 90 days or so).

There are a number of methodologies that can be followed to make the most effective use of time and professional resources in the purchase and implementation of an EHR. Sorting out the acceptable methods for both buying and configuring a software system goes much more smoothly once a specific plan is made, and the committee agrees to stick to the plan. Bringing a number of diverse plans together to hammer out what works for all professionals involved is a chore, but without a commonly accepted plan, likelihood of success is diminished.

If you're involved in a scenario like this, it's good to have a professional on hand to guide the committee, whether the group hires a full-time project director or gets guidance from a consultant, success is more likely with a good plan.


Terry McLeod

Electronic Health Records (EHRs) are a required part of our society, and improving business workflows with the EHR is imperative for the survival of your local mental health and addictions treatment clinics. Terry McLeod provides the bridge between the mental health and addictions professional and the technical world, as well as the glue to keep it working. Contact McLeod at and get more information from his website and blog,

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