Successful CPOE/EMR Rollout Offers Lessons To Other Hospitals

Montefiore Medical Center seems to have CPOE implementation down pat. The NYC-based facility saw an 85 percent reduction in its prescribing errors when it implemented CPOE, a very meaningful number given that the hospital’s staff place millions of prescriptions for inpatients every year. The hospital has attested to meeting Meaningful Use Level 1 standards, as well.

So what did they learn from the process?  Here’s some of the thoughts Jack Wolf, vice president and CIO of the facility, shared with  Becker’s Hospital Review:

  • Don’t delegate Meaningful Use to the IT department!  Some facilities treat Meaningful Use as a project belonging largely or totally to IT. This is a mistake, Wolf says. “MU has to be approached comprehensively by the hospital,” says Wolf, who has worked with the CFO and COO on the rollout. “If the organization believes that Meaningful Use is something that can be ‘put in’ the hospital, that is the wrong approach.”
  • Use a diverse implementation team:  Make sure you have representatives from different hospital areas identifying their unique needs, including each specialty and/or department. That way you can be sure you’re not installing something that will destroy productivity in those areas.
  • Make sure your system is very available:  Few things are more disheartening for clinicians than finding that the EMR, CPOE system or even the network itself is down. It’s critical to have both a backup system or at least a specific plan to implement these applications go offline. To Wolf, this is so important that it’s worth putting a redundant system in place;  he believes the investment is well worth it given the importance of these apps.
  • Create an optimization team:  Here’s an interesting one.  Montefiore apparently created a working group of expert users known as the “optimization team” whose job it was to improve the EMR and CPOE as it rolled out. When the team found errors, it would go back and re-train users on the updates, Wolf says.

Sounds like the common thread here is that Montefiore built out its system with input from the ground up, rather than by fiat from the C-suite.  From what I’ve seen, that approach rarely fails.