It's The End Of The World As We Know It
"How much is this going to cost me?"
Fair enough. Fiscal reality is, after all…fiscal reality, and this question is forced to the front of a number of business conversations I have. Often I just have to look the person in the eye and tell the truth: "I don't know". That's because getting an Electronic Health Record (EHR) to work isn't just a matter of buying software and relying on a vendor to get it up and running. If that were so, the job would be pretty simple. Unfortunately, a number of professionals and professional organizations do just that, and become quite disillusioned when they discover how much work it is to get the EHR running effectively.
Hence, our headline. Buying and implementing an EHR is a lot of work for the buyer, and the habit has been to self-implement. Sounds a bit like self-treatment, eh? Implementation is not explosive, it can be frustrating. It's not nuclear winter, it can be hot tempered moments. It's not business as usual, it is certainly The End Of The World As We Know It. Professionals need help buying and implementing their EHR as much as a consumer with depression or anxiety needs professional help.
We don't want to change much, just everything.
If the EHR starts with a software product that meets the needs of the professionals, software that's capable of delivering a way to increase the quality of interactions with consumers and let professionals help more people by decreasing paperwork, then it's a product that works and is usually sorely needed. Still, it's a vision. The productive EHR doesn't become a reality until it's implemented and the professional comes to rely on it for documentation, billing and even communications with other professionals serving the same consumer.
If the implementation of an EHR focuses on the specific workflows for administrative, clinical, medical and other professionals involved in helping consumers, then their work lives will be drastically changed for the better. Each of these workflows involves filling out different documents on the computer and producing the results of that input that's different depending on who needs the consumer information. The Electronic Health Record has changed the world for everybody who uses it productively and consumers can notice the change. Hopefully the change is positive and all that information at a professional's fingertips will help with the person's recovery.
The administrative person's world is changed by keeping track of consumers who have been served before, and are being treated now, or who have inquired about getting help since the EHR came on-line. Being able to instantly access even sketchy consumer information and avoid re-entry of data by having consumers verify information like their address and such saves time, enabling the administrative person to help more folks…typically making it through the day in a better mood because stress is diminished. Ask anybody working in this capacity of helping treatment professionals and you'll discover it's a mixed bag whether their work life is improved by the EHR. Their answer may change by the minute if the EHR has been only partially configured to their workflow. The short story here is that if their needs were considered in purchasing the software and if implementation paid attention to their needs (somebody has to ask them), their work lives are improved. They get more done with fewer errors, and less falls through the cracks.
Clinical and medical professionals experience the same phenomenon in different ways. When a nurse treats a consumer for an injury or illness, certain things are important: Lab results, recording vital signs, and medical treatment requirements. If the EHR is selected and implemented with them in mind, the software they see could be much different from the software the clinical professional uses even it's the same system. Clinical notes are concerned with addressing treatment goals and objectives, while medical notes are concerned with addressing health issues typically discovered by exams. The process of discovering a malady, diagnosing it, treating it and following through to assure healing happens is the same idea, but the actual tasks and subsequent measurement of success are quite different. That said, not only does the software need to do different things for these professionals, but the implementation needs to account for each of their workflows differently so the software tool will serve the consumer's needs well.
Changing the world with the EHR involves one great, very human component: fear. A software vendor is not likely to be around enough to help the staff overcome the fear. That's why it's a good idea to have a cracker-jack project manager on the inside when you're implementing the software that will change your world.