Overcoming Roadblocks to Data Enablement — HIMSS Future Care
By J. Bryan Bennett
Many healthcare organizations are on the journey to becoming data enabled. Unfortunately, a lot of themwill have a difficult time reaching it. Most organizations are just in the beginning stages, while some are still in the starting blocks. Additionally, there are many internal and external issues that may delay or stall the process. In this blog, we will discuss some of those ‘stumbling blocks’ and offer some suggestions on how to overcome them.
A previous blog discussed the three continuums an organization needs to address if it is going to become a data-enabled healthcare organization (DEHO). The three continuums are: data/technology, people/organization and process/workflow (see “Big Data Needs Big Three to Succeed”, August 8, 2013). If they do, they will have a better chance of success than those addressing this as purely a data or technology issue. In spite of that, there are still some major stumbling blocks that will impact the organization’s success. These will each be addressed by continuum.
Data / Technology
This is the continuum that gets the most attention. Most organizations have installed or are in the process of installing an electronic health record system. For many, the EHR alone has become a stumbling block. There have been delays on the part of the organization or the vendor that has cost millions of dollars in implementation costs and/or stimulus incentive money. Recently, articles have been published that discuss how CIOs have been terminated for buying a very popular EHR with a good reputation. Unfortunately, the real reason those CIOs were terminated was not because they choose this EHR solution but because they chose the wrong solution for their organization and/or didn’t have the right resources to implement the solution which led to extensive cost overruns.
To overcome this stumbling block, the organization has to first make sure they use a proper selection process. Not every solution will work for every situation. Second, they have to make sure they have the right resources to implement the solution. This will mean making a hard assessment of the staff’s capabilities to implement and customize the solution and/or determine if staff augmentation needs to be included in the budget. Third, they have to make sure they use proper project management methodologies. Without this, the implementation could spin out of control resulting in missed deadlines and exceeded budgets.
An area that is out of the organization’s control at this time is the lack of mainstream analytical tools. Most healthcare analytical tools are revenue cycle management focused, others are custom made or are being built into various EHR solutions. If your organization does not have one of the solutions with built-in analytics or can’t afford custom analytics, you could miss out on the real benefits of being data-enabled with the needed real-time decision support tools. A future blog will be dedicated to the current state of healthcare analysis tools. If you have any suggestions of products or companies that should be included, please contact me at firstname.lastname@example.org.
Process / Workflow
This continuum deals with the workflow of how the data is captured and managed. The biggest stumbling block on this continuum is gaining accurate data capture throughout the healthcare organization network. Some workflows may accurately capture data only some of the time when it needs to be accurately captured 100% of the time. Capture rates can vary by unit, hospital unit or hospital network. Some of this is addressed by the ‘People’ continuum stumbling block to follow.
This stumbling block is primarily overcome by utilizing the best workflow for your organization. When a software solution is purchased, some will follow your current workflow, some will force a workflow change to fit the solution, while the best will be flexible enough to incorporate your workflows into the industry best practices to maximize efficiencies.
People / Organization
There is still a lot of resistance to changing to an EHR by many in the provider community. From electronic charting to electronic order placement, providers have found many ways to keep from having to use the technology, including continuing to make verbal or telephone orders for the nurses to enter. This could result in the organization not meeting the stage 2 meaningful use requirements if it is done too often. To overcome this stumbling block, the organization has to help the providers embrace the change. This is difficult because we are making a change to an entire industry in a short amount of time. Telling them to embrace change is easy to say but difficult for most people to do.
To overcome this stumbling block, the organization has to manage the physician staff’s expectations. Physicians should be included in the EHR decision making and implementation planning process. The organization should also identify champions who naturally embrace the change and who will help drive the implementation amongst their peers. When an organization’s physician champion hears a colleague who is not completely on board complaining about the solution, they could help by providing positive and/or correct information. Lastly, make the physicians part of the ongoing process through recognition for usage and allowable incentives, for instance tracking and reporting on the top users of the solution.
We’ve discussed the three continuums in the previous blog and now the stumbling blocks in the way of becoming a DEHO. To implement these strategies is straightforward but requires a special skillset to manage. You need a good strategist, technologist, project manager, human behavior specialist and communicator all in one.
First, you will need to perform or have someone perform an assessment of where your organization is on each continuum. There is more to the continuums than has been covered in these blogs. Next, you will need to put a plan in place to advance your organization along the continuums recognizing the fact that there will be stumbling blocks that will need to be addressed. Lastly, follow your implementation plan looking forward to where you need to be while looking back at where you’ve been with an honest assessment of your capabilities and success.
Becoming a data-enabled healthcare organization is a journey. Treat is as such and you’ll have a successful and adaptable implementation.