While we may argue over the stats — is it 30 percent, 40 percent, even 50 percent? — everyone knows that the failure rates for hospital EMR installations are frighteningly high. So it never hurts to look at specific cases and see if we can avoid that particular train wreck.
So here you have it. Courtesy of medical informaticist Brian Martin, we have a compelling tale of a $50 million EMR installation that went belly-up largely because the hospital didn’t “get” the needs of its 1100+ community-based physicians. That’s $100,000 per bed, or if you prefer, $50,000 per staff physician, he notes. Ouch.
Since Martin tells the tale so well, I’ll turn the story over to him:
I did a post-implementation technology audit for the board of directors of a 500+ bed hospital with 1100+ physicians on staff. The hospital had spent over $50 million acquiring and deploying the then Alltell/Eclipsys EMR/CPOE system, which at that time ran on an IBM ES/9000 mainframe.
Soon after implementation, BoD members fielded numerous complaints from staff physicians who refused to use the system because of its perceived lack of usability…
Fast forward a few years; the BoD approved a significant expenditure to replace the EMR/CPOE system with Epic…Note that the Eclipsys system was based on a very successful implementation of the original Lockheed/Technicon Data Systems CPOE in use at the NIH Clinical Center, so we were dealing with field-tested and validated software that had seen successful clinical implementations.
The implementation failure had more to do with not understanding the technological needs and expectations of community-based independent physicians who comprised the hospital’s staff physicians, and therefore not incorporating their needs and expectations into the technology selection process.
<clap clap clap> What a great overview! Much to think about there. It’s definitely a reminder that even the best EMR technology isn’t worth much if users balk. (Why we’d need that reminder at this point, I can’t imagine, but hospitals still steamroll EMRs over unwilling docs regularly.)
I’d like to think that this kind of fiasco is largely a thing of the past. With Meaningful Use forcing hospitals and doctors to work together more closely, one would hope that boards of directors would build acceptance before they spend, if for no other reason than they’ll get walloped later if they don’t.
But hospital leaders are still among the most conservative creatures on earth, and the kind of top-down style we see in action here isn’t going anywhere soon. Oh well — what’s a $50M mistake among friends?