When Some People Talk: Implementation of an Electronic Health Record (EHR)
Yes, I actually try to listen. Sometimes.
Richard Blumenthal is one of the folks I listen to when he speak because he's the National Coordinator of HIT and impacts my interests and business. I ran across his opinions recently in Healthcare Technology News and I couldn't resist commenting, since the opinions revolve around trends in healthcare IT.
Blumenthal feels ARRA's IT aims are being met. At the risk of repeating myself, I tend to agree. The Electronic Health Record (EHR) has used all the attention to spring out of the gate, with increasing sales of software due to the incentives offered Behavioral Health lags behind, but see my last post to understand why I feel Mental Health and Substance Abuse Treatment will soon catch up with the rest of healthcare IT.
Lately, my work has led me to help organizations who have never fully implemented their EHR, which was purchased years ago. They are finding themselves realizing the benefits they originally purchased the system for, much later than expected. Scheduling is working better for professionals, there are shorter wait times for consumers, and management is getting figures they need to project how they need to do business in the short-term and into the future. The value of the EHR is coming to the forefront.
Implementation of the software was originally not accomplished due to a number of factors, not the least of which was the inability to foresee that a software implementation would take as much effort on the parts of the employees as it did. This led to inefficiencies in the implementation effort like having to re-train some staff members in the mission critical efforts (usually those affecting billing or the largest piece of revenue). In short, when the implementation dollars were spent, the project stalled and a bundle of software features like scheduling, assessments, treatment plans and progress notes never made it into daily life at the organization. The vendor and the customer often came to an impasse that so adversely affected their business relationship that the EHR was never implemented. What this meant to the consumer was about a year and a half of disorganization for people supposed to be helping them. In some cases there were ever-increasing delays in getting needed treatment, which led to no-shows, resulting in poorer service to customers and some people not getting the help they need at all.
Another barrier to implementation has been acceptance by doctors. Usually they just didn't want to slow down to learn how to use the software...in some cases, the software wasn't designed with their workflow process in mind. These days more and more doctors are being drawn into using the EHR by their peers. I've seen this happen in the field, and many doctors using the EHR love it. Some wait to retire, never learning to use the software. I find the same pressures to use the EHR come to bear throughout a Mental Health or Substance Abuse Treatment environment...nurses, counselors, administrators, even executives are feeling the peer pressure and learning the systems.
In some cases, this shift requires a new software purchase and implementation. Folks discovered the vendors are better at that job these days, and staff is more accepting of the change. In other instances, staff has been so impacted by The Internet and home computer use (Facebook and Email are really big hits with all demographics), they are more accepting of the EHR and learn how to use it more quickly.
So, a psychological change is under way in organizations in this sector. People are more accepting of technological change these days, and a few are even enthusiastic. The EHR is spreading, and the results are helping consumers, professionals and helping organizations.