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Software Selection Done Right Part 2: Presenting a Vision through an RFI

Posted on August 22, 2016 I Written By

For the past twenty years, I been working with healthcare organizations to implement technologies and improve business processes for nearly twenty years. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

Be sure to check out part 1 in the series.

The primary driving document of a software selection is often the RFI or RFP, the invitation to vendors to participate in the process.. In future articles in this series, we will discuss the process of software selection and obtaining buy-in from stakeholders after the RFI has been received. For this week, we will focus on that centerpiece document, the RFI. This document sets the stage for the process, creating the tone and establishing the way that the hospital will work with the vendor during the selection.

However, far too often creating this document becomes the focus of the process rather then the actual selection. Creating an RFI should not be a large effort and done properly, can be one of the easier steps, allowing the journey to begin much faster.

The purpose of an RFI should not be to provide a laundry list of needs and wants to the software vendors. An RFI that includes pages of checklists of features can take a considerable effort to create and an even more considerable effort for the vendor, and actually adds little value. When it comes to mature software solutions, such as ERP and EHR solutions, it is very likely that the vendor understands your needs better than you do. They demonstrate software to hospitals every day, and have numerous customers who have been through the same changes and challenges that you have.

Several years ago I was working alongside an ERP software sales team and joined a meeting in which a potential customer had allowed them to present their solutions following completion of an extensive, laundry list style RFI. During the discussion the potential customer’s CIO was present and was looking through the response to the RFI carefully, with a frown on his face.

Then he looked up and asked a question. “I am reviewing your response to our RFI”, he said, “and I see that you answered no to many of the items in our requirements. Why should we choose you over another vendor who met more of those needs.” The salesperson from the ERP team was not only a seasoned salesperson, but also well versed in the business processes of ERP and was well prepared with an answer that I often reference to this day.

“Do you know what a Japanese auction is?”, he asked the CIO. “Actually”, he continued, “does anyone here know what a Japanese auction is?.” Everyone looked confused, but no one spoke.

“I don’t, but why would you ask that?” inquired the CIO.

“Because it is a requirement of the software in your RFP”, the salesperson responded, “and one of the examples where we said no”. He then went on to explain what a Japanese auction was to the hospital team, and asked if they would ever use that functionality. They all agreed that they would never have a use for it. In closing the salesperson asked what consulting firm wrote the RFI for them and if they were advised that they needed to include it, or if the consultant simply forgot to remove it from the template they were using.

This story highlights that the software vendor is well aware of the features and functionality that a hospital would typically use, and does not need a list of those features. It also demonstrates that paying a third party to develop an RFP does not always lead to a more effective document – and in some cases leads to a less effective document.

Rather than a laundry list of features, an RFP should tell a story. The story of who you are, where you are now, and where you want to go. It should explain the vision and objectives of your project, the organization’s current challenges, and your future vision for the hospital with the new software. The RFP should invite the vendor to participate and present how they will help you to achieve those goals. Each vendor can then present why their solution is the best to get you to your desired destination.

Specific features and functions are much less of a key difference between software solutions today. Feature lists have actually led many vendors to write and acquire software for the purpose of being able to check boxes in an RFP rather than reacting to actual customer needs or with the intent of producing a quality product. It is increasingly unlikely that a “smoking gun” will be found with a specific absolutely necessary feature existing in one vendor option but not the other. Rather, it is the design and the quality of the solution that is important, as well as confidence in the vendor and their ability to partner with you effectively and capability to deliver on their promises.

Indeed there is more to an RFP – and in a future article we will discuss how to define the rules of the road of the selection process and to make sure those rules are reflected in the RFP and that the vendors and staff follow those rules. However, the core content of an RFP is expressing that vision to your potential software partners.

Therefore rather than spending months of creating lists of checkboxes of features that you may or may not need, just tell your story. Explain the vision of where you want to go and invite the potential solution providers to explain to you how they will help you to achieve that vision. The result will not only be a significantly faster selection process, but also a better relationship with your vendor partners during the selection and beyond.

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

Managing Health Information to Ensure Patient Safety

Posted on August 17, 2016 I Written By

Erin Head is the Director of Health Information Management (HIM) and Quality for an acute care hospital in Titusville, FL. She is a renowned speaker on a variety of healthcare and social media topics and currently serves as CCHIIM Commissioner for AHIMA. She is heavily involved in many HIM and HIT initiatives such as information governance, health data analytics, and ICD-10 advocacy. She is active on social media on Twitter @ErinHead_HIM and LinkedIn. Subscribe to Erin's latest HIM Scene posts here.

This post is part of the HIM Series of blog posts. If you’d like to receive future HIM posts by Erin in your inbox, you can subscribe to future HIM Scene posts here.

Electronic Medical Records (EMRs) have been a great addition to healthcare organizations and I know many would agree that some tasks have been significantly improved from paper to electronic. Others may still be cautious with EMRs due to the potential patient safety concerns that EMRs bring to light.

The Joint Commission expects healthcare organizations to engage in the latest health information technologies but we must do so safely and appropriately. In 2008, The Joint Commission released Sentinel Event Alert Issue 42 which advised organizations to be mindful of the patient safety risks that can result from “converging technologies”.

The electronic technologies we use to gather patient data could pose potential threats and adverse events. Some of these threats include the use of computerized physician order entry (CPOE), information security, incorrect documentation, and clinical decision support (CDS).  Sentinel Event Alert Issue 54 in 2015 again addressed the safety risks of EMRs and the expectation that healthcare organizations will safely implement health information technology.

Having incorrect data in the EMR poses serious patient safety risks that are preventable which is why The Joint Commission has put this emphasis on safely using the technology. We will not be able to blame patient safety errors on the EMR when questioned by surveyors, especially when they could have been prevented.

Ensuring medical record integrity has always been the objective of HIM departments. HIM professionals’ role in preventing errors and adverse events has been apparent from the start of EMR implementations. HIM professionals should monitor and develop methods to prevent issues in the following areas, to name a few:

Copy and paste

Ensure policies are in place to address copy and paste. Records can contain repeated documentation from day to day which could have been documented in error or is no longer current. Preventing and governing the use of copy and paste will prevent many adverse issues with conflicting or erroneous documentation.

Dictation/Transcription errors

Dictation software tools are becoming more intelligent and many organizations are utilizing front end speech recognition to complete EMR documentation. With traditional transcription, we have seen anomalies remaining in the record due to poor dictation quality and uncorrected errors. With front end speech recognition, providers are expected to review and correct their own dictations which presents similar issues if incorrect documentation is left in the record.

Information Security

The data that is captured in the EMR must be kept secure and available when needed. We must ensure the data remains functional and accessible to the correct users and not accessible by those without the need to know. Cybersecurity breaches are a serious threat to electronic data including those within the EMR and surrounding applications.

Downtime

Organizations must be ready to function if there is a planned or unexpected downtime of systems. Proper planning includes maintaining a master list of forms and order-sets that will be called upon in the case of a downtime to ensure documentation is captured appropriately. Historical information should be maintained in a format that will allow access during a downtime making sure users are able to provide uninterrupted care for patients.

Ongoing EMR maintenance

As we continue to enhance and optimize EMRs, we must take into consideration all of the potential downstream effects of each change and how these changes will affect the integrity of the record. HIM professionals need prior notification of upcoming changes and adequate time to test the new functionality. No changes should be made to an EMR without all of the key stakeholders reviewing and approving the changes downstream implications. The Joint Commission claims, “as health IT adoption becomes more widespread, the potential for health IT-related patient harm may increase.”

If you’d like to receive future HIM posts by Erin in your inbox, you can subscribe to future HIM Scene posts here.

Is It a Hot or Cold Hospital EHR Buying Market? – Response

Posted on August 15, 2016 I Written By

For the past twenty years, I been working with healthcare organizations to implement technologies and improve business processes for nearly twenty years. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

This article is in response to John Lynn’s recent posting, Is It a Hot or Cold Hospital EHR Buying Market?

In his recent posting, John Lynn asked the question “Is it a Hot or Cold Hospital EHR Buying Market?”. In it he highlights a recent KLAS report that over 490 hospitals, a staggering 10% of the entire market, were involved in an EHR decision in 2015. After reading his posting, I wanted to take a moment to share my observations.

2015 was indeed an amazing year for EHR sales, partly driven by the pending sunset date of Mckesson Horizon forcing many customers to switch EHR solutions. Some of those customers are going to Paragon, but many more purchased or are evaluating other solutions. During a recent trip to Epic University, I was surprised to find that nearly half of the attendees of the classes were hospitals switching from Mckesson Horizon to Epic – and all had just recently completed their purchases (late 2015/early 2016) and were facing the same live dates of late 2017/early 2018.

Hospitals who have purchased and implemented Epic or Cerner are very unlikely to make a change. Regardless of which solution is preferred, the investment in these solutions and the level of effort required to switch from one to another is so high, that it would take a significant triggering event for a hospital to make that change. Therefore it is likely that customers on these solutions will not be making a change in the near future.

However, KLAS reports that nearly 40% of MEDITECH customers would change EMR’s if they could, and that Paragon customers also report unrest. Therefore in addition to the shrinking number of those that have not implemented a viable EHR solution, the possibility that there will be a wave of customers switching from one of these solutions to Epic or Cerner remains a consideration. There is also the question of how the recent spin-off of Mckesson’s software division will impact the future of Paragon. If Paragon were discontinued or sold, it could lead to another explosion of EHR decisions. If instead there was a significant investment in the solution, it could become a more viable alternative as customers look to switch from one EHR to another.

I suspect that 2016 will be another strong year from EHR sales in general and for Epic and Cerner in particular. Beyond that, much will depend on the strength of the other solutions and which ones break out into the top tier. Regardless, the recent explosion of EHR sales and the rush to replace Horizon will in many cases lead to minimized installs – where the bare minimum work was completed and there is significant opportunity to improve business processes, implement new modules, and roll out advanced functionality within those solutions. As a result I believe that within a few years, the market will be more stabilized with fewer customers switching solutions, and instead focusing on maximizing what they have.

Unless another player comes in and disrupts the marketplace or a significant shift in the industry creates a reason to make a change yet again…

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

Is It a Hot or Cold Hospital EHR Buying Market?

Posted on August 12, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In a recent blog post by Erik Bermudez, he asks the question about whether the Hospital EMR market is heating up or cooling down. He suggests that it’s heating up and offers this commentary as proof:

In 2015, KLAS validated that over 490 acute care hospitals were involved in an EMR contract decision of some kind, which represents an increase of almost 200% over 2014. That’s nearly 10% of the entire US hospital market making an EMR decision in 2015 alone.

We’ll see if this trend continues. No doubt there was a cooling off of the market as meaningful use matured in 2014. Given that cooling off period, it’s not really a surprise that it would start to heat up.

Eric also points out that buzzwords like population health and interoperability are dominating the conversation as opposed to EHR. I’d in the healthcare analytics buzzword to that list. These are indeed hot topics, but what’s interesting is that each of these topics really requires an EHR. You’re not likely to buy a healthcare analytics system if you don’t have an EHR. You need the data to be electronic (presumably in an EHR) to do the analytics (yes, I know there are edge cases where you don’t).

Given this dependency on EHR, we shouldn’t be surprised that many organizations are making an EMR decision. No doubt some healthcare organizations have an EMR that doesn’t support the advanced population health, interoperability and analytics initiatives they’d like to do. No doubt these advanced efforts are going to drive adoption of new EHR vendors that can support these efforts.

What do you think? Is the EHR buying market hot or cold? Let us know your thoughts in the comments.

EHR Data Migration – Tackling EHR & EMR Transition Series

Posted on August 10, 2016 I Written By

EHR Data Migration
(See Full EHR Data Migration Infographic)

In this infographic, Galen Healthcare Solutions provides critical information and statistics pertaining to EHR data migration including:

  • Healthcare Data Growth
  • EHR Data Migration Drivers
    • Mergers & Acquisitions
    • System Consolidation
  • EHR Data Migration Challenges
  • Industry Leading EHR Migration Solution

The demand for data migration within the U.S. healthcare market is growing exponentially. The increase in mergers and acquisitions is driving system consolidation as is the increasing number of HCOs seeking EHR replacements to address usability and productivity concerns. A recent survey by Black Book Rankings found that nearly one-fifth of large practices and clinics intend to undergo an EHR replacement by the end of 2016. In addition, a 2015 Kalaroma report shows that the EHR replacement market will grow at an annual rate of 7-8% over the next five years.

EHR Data Migration Process

The process of migrating from one EHR to another is among the most difficult technical and functional projects a healthcare organization will ever confront. The EHR transition requires vendor selection, assessment and scoping, legacy system optimization, data migration, legacy application support, data archival, and new system implementation. If organizations fail to address any of these components properly, their migration could leave healthcare providers without the information needed to make the best patient care decisions, and organizations without easy access to the historical data necessary for participating in quality reporting initiatives and other current and emerging value based care reimbursement methodologies.

Learn more about EHR transition, replacement and migration strategies, methodologies, tips & tricks, and best practices by downloading our EHR Migration Whitepaper.

About Justin Campbell
Justin is Vice President, Strategy, at Galen Healthcare Solutions. He is responsible for market intelligence, segmentation, business and market development and competitive strategy. Justin has been consulting in Health IT for over 10 years, guiding clients in the implementation, integration and optimization of clinical systems. He has been on the front lines of system replacement and data migration and is passionate about advancing interoperability in healthcare and harnessing analytical insights to realize improvements in patient care. Justin can be found on Twitter at @TJustinCampbell

About Galen Healthcare Solutions

Galen Healthcare Solutions is an award-winning, #1 in KLAS healthcare IT technical & professional services and solutions company providing high-skilled, cross-platform expertise and proud sponsor of the Tackling EHR & EMR Transition Series. For over a decade, Galen has partnered with more than 300 specialty practices, hospitals, health information exchanges, health systems and integrated delivery networks to provide high-quality, expert level IT consulting services including strategy, optimization, data migration, project management, and interoperability. Galen also delivers a suite of fully integrated products that enhance, automate, and simplify the access and use of clinical patient data within those systems to improve cost-efficiency and quality outcomes. For more information, visit www.galenhealthcare.com. Connect with us on Twitter, Facebook and LinkedIn.

Hospitals, Groups Come Together To Create Terminology For Interoperability

Posted on August 5, 2016 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

A health IT trade coalition dedicated to supporting data interoperability has kicked off an effort providing fuel for shareable health IT app development.

The Healthcare Services Platform Consortium, whose members include Intermountain Healthcare, the American Medical Association, Louisiana State University, the Veterans Health Administration and the Regenstrief Institute, is working to increase interoperability by defining open, standards-based specifications for enterprise clinical services and clinical applications.

Its members came together to to create a services-oriented architecture platform that supports a new marketplace for interoperable healthcare applications, according to Healthcare Informatics. Stan Huff, MD, CMIO of Intermountain, has said that he’d like to see more shareable clinical decision support modules developed.

Now, in furtherance of these goals, HSPC members are throwing their support behind an initiative known as SOLOR, which calls for integrating SNOMED CT and Laboratory LOINC, as well as selected components of RxNorm. According to the group, SOLOR will provide a terminology foundation for CIMI (Clinical Information Modeling Initiative) efforts, as well as FHIR profile development.

“We hope SOLOR can serve as a foundation to deliver sharable clinical decision-support capability both within the VA and ultimately throughout the nation’s healthcare system,” said Veterans Health Administration deputy CMIO for strategy and functional design Jonathan Nebeker, M.S., M.D., in a prepared statement.

Ultimately, HSPC hopes to create an “app store” model for plug-and-play healthcare applications. As HSPC envisions it, the app store will support common services and models that vendors can use to shorten software development lifecycles.

Not only that, the evolving standards-oriented architecture will allow multiple providers and other organizations to each deliver different parts of a solution set. This solution set will be designed to address care coordination, gaps in workflow between systems and workflows that cut across acute care, ambulatory care and patient-centered medical home models.

Industry players have already created a small selection of apps built on the SMART technology platform, roughly three dozen to date. The apps, some of which are experimental, include a tool estimating a patient’s cardiac risk, a SMART patient portal, a tool for accessing the Cerner HIE on SMART and an app called RxCheck offering real-time formulary outcomes, adherence data, clinical protocols and predictive analytics for individual patients.

Now, leaders of the HSPC – notably Intermountain’s Huff – would like to scale up the process of interoperable app development substantially. According to Healthcare Informatics, Huff told an audience that while his organization already has 150 such apps, he’d like to see many more. “With the budget we have and other constraints, we’ll never get from 150 to 5,000,” Huff said. “We realized that we needed to change the paradigm.”

Hospital Software Selection Done Right – Part 1: Introduction

Posted on August 1, 2016 I Written By

For the past twenty years, I been working with healthcare organizations to implement technologies and improve business processes for nearly twenty years. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

Making a decision on which new EHR, ERP, or other major software solution is a process that must be taken seriously. The right decision can lead the hospital to the next level of automation, efficiency, and patient safety. The wrong decision can lead to a disaster, and therefore be a career-limiting move for those that make it. In addition, the right decision is subjective. Those that did not participate in the selection process may have their own opinions. At best, they could exhibit behaviors of frustration with the decision or passive resistance. At worst, they could actively look for opportunities to challenge the project decisions and increase risk of failure.

Over the course of several articles I will be analyzing the software selection process piece-by-piece and share the key components of a successful software selection. We will be looking at the process from a variety of goals and perspectives. This will include making sure that the result is the best possible solution, ensuring the process is run effectively, and getting engagement from the right members of the hospital staff to obtain buy-in and excitement, or at least acceptance, of the end decision.

An effective software selection starts with assembling the right team which must be a good representation of the user base while also being nimble enough to make effective decisions. In the first article of the series, I will share suggestions and lessons learned about how to structure and staff software selection teams including engaging physician and clinical staff in the process.

Additional articles will look at the RFI/RFP process and how to create an effective RFP with minimal effort, including critical aspects of content and how to complete the RFP process with minimal or no third party assistance. Often healthcare organizations spend significant amounts of money and time creating RFP documents that provide minimal value and slow down the selection process.

I will also look at the process of narrowing down vendors and actual selection logistics. That includes what to look out for in vendor demonstrations, how to maximize the time of your staff, surveying, reference checks, and driving to final decisions.

I hope that readers enjoy the articles and find that it helps you as you plan future software selections. Please share where you agree and disagree as well as comments and suggestions along the way.

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

Hospitals Using Market-Leading EHR Have Higher HIE Use

Posted on July 29, 2016 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

A new study concludes that hospital engagement with HIEs is tied with the level of dominance their EHR vendor has in their marketplace. The study, which appeared in Health Affairs, looked at national data from 2012 and 2013 to look at how vendor dominance related to hospitals’ HIE involvement level. And their analysis suggests that the more market power a given vendor has, the more it may stifle hospitals’ HIE participation.

As researchers note, federal policymakers have expressed concern that some EHR vendors may be hampering the free flow of data between providers, in part by making cross-vendor HIE implementation difficult. To address this concern, the study looked at hospitals’ behavior in differently-structured EHR marketplaces.

Researchers concluded that hospitals using the EHR which dominated their marketplace engaged in an average of 45% more HIE activities than facilities using non-dominant vendors. On the other hand, in markets where the leading vendor was less dominant, controlling 20% of the market, hospitals using the dominant vendor engaged in 59% more HIE activities than hospitals using a different vendor.

Meanwhile, if the dominant EHR vendor controlled 80% of the market, hospitals using the leading vendor engaged in only 25% more HIE activities than those using a different vendor. In other words, high levels of local market dominance by a single vendor seemed to be associated with relatively low levels of HIE involvement.

According to the study’s authors, the data suggests that to promote cross-vendor HIE use, policymakers may need to take local market competition between EHR vendors into consideration. And though they don’t say this directly, they also seem to imply that both high vendor dominance and low vendor dominance can both slow HIE engagement, and that moderate dominance may foster such participation.

While this is interesting stuff, it may be moot. What the study doesn’t address is that the entire HIE model comes with handicaps that go beyond what it takes to integrate disparate EHR systems. Even if two hospital systems in a market are using, say, Cerner systems, how does it benefit them to work on sharing data that will help their rival deliver better care? I’ve heard this question asked by hospital financial types, and while it’s a brutal sentiment, it gets to something important.

Nonetheless, I’d argue that studying the dynamics of how EHR vendors compete is quite worthwhile. When a single vendor dominates a marketplace, it has to have an impact on everyone in that market’s healthcare system, including patients. Understanding just what that impact is makes a great deal of sense.

Most Hospitals Offer Patients Online Access To Medical Records

Posted on July 27, 2016 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

New research from the American Hospital Association suggests that nearly all hospitals now offer individual patients online access to their medical records, and most offer them the ability to perform related tasks as well.

According to AHA research, 92% of hospitals gave patients access to their medical records in 2015, up from 43% in 2013. Also, 84% allowed them to download information from the record, 78% let them request changes to their record and 70% made it possible for them to send a referral summary. (The latter has seen the biggest change since 2013, as only 13% could send such a summary at that time.)

In addition, hospitals have begun giving patients the ability to schedule appointments, order prescription refills and pay bills. As the AHA notes, progress on this front isn’t universal, as organizations need to integrate data from revenue cycle, pharmacy and scheduling systems to make it happen. But as hospitals invest in integration engines they will have a greater ability to roll out these options.

As of 2015, 74% of hospitals let patients pay bills online, up from 56% in 2013. However, progress on other consumer-friendly functions has been slower. Only 45% of hospitals let patients schedule appointments online, a modest increase from 31% in 2013, and just 44% let patients refill prescriptions, up from 30% in 2013.

Meanwhile, hospitals are slowly but surely expanding tools letting patients communicate with physicians. The AHA found that 63% let patients securely message care providers, up from 55% in 2014, and 37% let patients submit self-generated data, a big jump from the 14% who did so in 2013.

All of this suggests that rollouts of patient portal tools are likely to continue well after Meaningful Use has landed in the dustbin. After all, research suggests that dollars spent on these technologies will pay off, especially under at-risk value-based care models.

For example, an eye-opening study appearing in Health Affairs found that use of patient-physician email at Kaiser Permanente is associated with a 2% to 6.5% improvement in HEDIS performance measures like HbA1c levels, cholesterol and blood press screening and control. The same study noted that users of its My Health Manager were 2.6 times more likely to remain KP members than non-users, a phenomenon which may well apply to providers.

On the other hand, hospitals need to evaluate any potential portal solutions carefully. According to a study by research firm Peer60, many solutions have serious limitations that could lead providers to violate state laws or limit parent and minor engagement. Also, some organizations might not be ready to support patients who have issues adequately. Concerns like these might explain why 28% of the 200 healthcare execs surveyed by Peer60 said they weren’t looking at portal technology at the moment.

Another Look At Easing EMR Adoption Problems

Posted on July 22, 2016 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Though EMRs are no longer a brand-new thing, rolling them out is still a difficult challenge for hospitals. After all, even the best platforms can require significant changes in staffers’ day-to-day work, which isn’t easy for anyone. And some less technology-savvy workers may struggle to pick up new routines. Plus, we’re still seeing a lot of EMR implementations as hospitals switch EHR vendors, EHR vendors get sunset, and hospitals get acquired by larger hospitals with different EHR.

So I was interested to read yet another take on how hospitals can survive this tumultuous period. This one comes from Next Services, an Ann Arbor, MI-based health IT software and consulting firm. Here’s some of the more interesting steps Next Services offers to help smooth out the adoption process:

  • Have managers create a 3×3 matrix sorting key players by skill and resistance. Along the top, divide the rows into high, medium and low skill sets, then along the left side, label three columns for high, medium and low resistance levels. Sorting workers into categories such as high skill/low resistance, high skill/high resistance, low skill/high resistance and so on can help managers predict what issues will arise for individual workers.
  • Roll out EMR in modules rather than phases, and don’t go to the next set of modules until you and your team are hundred percent confident that everyone can use them. Also, start with core modules that help document the basic chart, then expand outward to modules with greater functional depth.
  • Prepare staff for crises. Think through all of the ways that the rollout could go wrong during live patient care use, and make sure staffers are prepared to react appropriately when such an event happens.
  • Think of the rollout as a game. To encourage staffers, offer points for important factors such as knowledge, helpfulness and speed. Then put a chart presenting the results on a big monitor for everyone to review at the end of the day.
  • Celebrate your successes. Celebrating small wins with the staff during the rollout can help keep the atmosphere positive. Celebrations can be anything from an ice cream social to a simple group cheer.

While I find these suggestions to be interesting and useful, I’d love to see a companion list providing suggestions on how hospitals and health systems can help staffers cope with a second or third EMR rollout. My guess is that such a transition poses different management challenges than pulling the switch the very first time.

As I see it, such implementations could range from toxic (staff was exhausted by the first rollout and doesn’t want to play this time) to comparatively easy (staffers learned a lot the first time, and find additional changes to be less upsetting than they did the initial go-live). And obviously, much will depend upon how the next implementation is managed, how training is presented and how the previous rollout went.

Still, there must be ways to ease the blow regardless. What suggestions would you have for health IT leaders who are navigating their second or more EMR rollout?