When it comes to EHRs, 'Installation does not equal implementation'
When it comes to your organization successfully adopting electronic health records, it's not just a matter of "going live" with the technology, says Don Harrison, co-leader of the Sunday workshop titled "Solving the Healthcare IT Adoption Dilemma," at the 2013 HIMSS Annual Conference & Exhibition.
"Installation does not equal implementation," says Harrison, founder and CEO of Implementation Management Associates, Inc. Many organizations want to purchase the best technology, but fail to take into account the most important factor for success–human behavior.
If an organization wants to get an exponential return on investment, at the fastest speed possible, they need to shift their thinking from focusing only on time and budget to focusing on human behavior and how to reinforce it, Harrison says. This will involve breaking away from annual, semi-annual or even quarterly reviews linked to financial rewards. Behavioral standards need to be set up, measured, and managers need to reinforce the desired behavior regularly.
After the implementation team has come and gone, an organization needs to invest in "change agents"–those specialized in helping to change human behavior, Harrison recommends. It's important that the change agents first gain trust and credibility with the users.
A change in the culture will need to take place from the top–a sponsorship, he adds. Leaders within the organization need to be sponsors of the change, even if this means redefining "success" as it is currently defined by an organization's culture.
Claire McCarthy, MA, FHIMSS, co-leader of the workshop cited an example of good behavior is when physicians show the EHR to the patient and discuss it with the patient. This is creating the desired effect of building trust between the patient, the doctor, and the new technology.
Harrison and McCarthy both warn that effective training of end users must take place from the end users' point of view. If physicians are insecure that they might be made to look foolish before their peers, then alter the training to be one-on-one, McCarthy recommends. If the computer requires a certain minimum typing speed, or it shuts down, then lower the speed to accommodate the users, Harrison says.
The most expensive aspect of implementation is resistance, Harrison says. The best way to fight this is with "readiness" training, before the IT goes live. "Resistance is always logical and correct to the people having it," he adds. It's important to allocate resources to handling resistance, he warns.
McCarthy says most organization leaders have an "ah ha" moment, when they realize that people are what is holding back implementation, not the IT. Human objectives must be "observable and measurable," she says. "You want to notice if anything is happening, because if you see it, you want to reinforce it."