EMR success rests on culture change, MD buy-in, executive leadership

We know, we know, you've heard this before: It takes executive leadership, a willingness to change the organizational culture and, of course, physician buy-in to make an EMR implementation both worthwhile and successful.

At the Institute for Health Technology Transformation's Winter Health IT Summit in Chandler, Ariz., this week, Banner Health's senior director for clinical informatics, Judy Van Norman, explained how she had to spend about 80 percent of her time on cultural change--not the nuts and bolts of technology--to help the Phoenix-based organization implement its vision of EMR-enabled care transformation. "This project is not an IT project," Van Norman said. "The bigger part of the work is the people piece."

That's pretty much what has gone on at Lehigh Valley Health Network in Allentown, Pa., too, which installed EMRs in more 25 ambulatory medical practices and will reach 40 more by the end of 2012. "In some cases, our EMR teams have spent as much as 80 percent of their time working with the practice on office workflow," Information Services Clinical Applications Director Lori Yackanicz writes in Hospitals & Health Networks.

Cultural issues have been a big part of that. "With our initial implementations, we tailored the clinical templates to the demands of our different physician groups," Yackanicz writes. "But it soon became apparent that over-customization was imposing a greater workload on the EMR teams trying to support and maintain the systems. It also was having a negative effect on the overall system response time and making it very difficult to pull clinical data."

So the IS department brought in physicians to help standardize clinical templates for each division and specialty, then enlisted physician champions to help sell other doctors on the idea of cultural change and the EMR as a vehicle for quality improvement.

For more information about the Lehigh Valley strategy:
- read Yackanicz's commentary in Hospitals & Health Networks

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