EMR leaders

Market factors have driven strong demand for implementation of inpatient clinical electronic medical record (EMR) systems and hospitals are in a constant cycle of installing, replacing, upgrading or adding functionality to support inpatient EMRs. EMR implementations face a number of challenges, not the least of which is obtaining clinician buy-in. As part of its ongoing research effort to develop its EMR Short List reports, Health Industry Insights spoke with many end users who have experienced inpatient EMR selection and implementation and evaluated their challenges and successes.

A key finding of the research was that one of the most important best practices for hospital IT professionals during EMR implementation was to involve physicians early in system selection and implementation decisions. Involving physicians early in selection made EMRs more successful at achieving an organization’s goals.

Adding physicians now to make them EMR leaders later
By involving physicians early in the decision making process, physicians develop a personal investment in the project and are more likely to advocate use of the EMR to their colleagues once it’s a reality. Peer-to-peer interaction between clinicians during EMR adoption can also provide valuable support.

Clinical insights into selection decisions
IT professionals know that system selection involves tradeoffs, but understanding these tradeoffs can be key to user acceptance. It helps for providers to understand that every feature isn’t in every system – and that sometimes selecting a particular product means compromising in one area in exchange for added efficiencies in others.

Providing clinician input in tough calls
IT professionals need a clinical perspective to understand the impact of a tradeoff and having physician involvement can help to assess the clinical value of particular features and configuration options when making decisions.

True process improvement and clinical transformation
The ability of an organization to meet the goals of an EMR project is closely tied to the facility’s underlying ability and readiness to transform its administrative and clinical processes. Physician involvement in an EMR project fosters an environment where IT can get a realistic understanding of organizational readiness and the impact of the changes required to meet clinical process improvement goals.

Neutralizing resistance early
In situations where providers resist efforts to place orders and/or document clinical notes electronically, the EMR is less efficient and benefits to the facility are decreased. The persistence of paper components of medical records, or the wide-scale incorporation of scanned document content reduces the overall efficiency of the EMR. Physician and nurse participation in system selection can help identify electronic documentation and ordering solutions that have simple and intuitive functionality in the eyes of clinicians, and meet the needs of the facility. 

EMR implementations fail when they don’t hit adoption targets, face strong resistance from clinical staff, and do not accomplish the process changes and other organizational goals set out. In many cases, failures occur because implementers did not provide the underlying support in the form of training, preparedness and assistance during the initial stages of implementation. Physician advocates can help to inform this process and provide assistance via peer-to-peer interactions. Active participation can help clinical staff to better understand tradeoffs that need to be made during the decision process, and lessen the likelihood of widespread resistance to adoption. Regardless of the actual functionality, leadership and acceptance of the EMR by clinical staff are critical to EMR implementation success.

Health Industry Insight’s EMR Shortlist tool is designed to provide a customized, fact-based analysis for individual projects that can help guide decisions for stakeholders. Inpatient EMR Shortlist, the first report in a two-part series, was published on April 23, 2008 and is available at http://www.healthindustry-insights.com/HII/getdoc.jsp?containerId=HI211721. A complimentary web conference covering the 9 IT suppliers and their inpatient EMR systems featured in that report will be held May 1st at 3:00 p.m. EDT.

For more information about the EMR research, or to share your experience with an EMR, EMR selection or implementation process, please contact Judy Hanover at jhanover@healthindustry-insights.com. 

Judy Hanover serves as research manager for Health Industry Insights’ healthcare provider practice. An industry veteran, Hanover brings expertise in health care and the life sciences to her role, and provides research and market analysis on healthcare informatics.