Tom Pettibone: EHR implementation--are you ready for change?


The U.S. government has set an aggressive goal for the healthcare industry, ensuring every American has an electronic healthcare record by 2014. As President Obama's recovery package rolls out over the next several years, hospitals and healthcare providers must ask themselves if they are willing and prepared to implement EHR and transform their 'pencil and paper' record-keeping system into a new electronic system.

The billions of dollars allotted for healthcare IT investment and the millions offered in incentive for switching to an EHR system are certainly motivating, but some may ask, "Other than the money, what else does an EHR implementation have to offer?"

While there is talk of the general benefits EHR can bring to the operations of the healthcare system, the most important is that EHR has real life-saving potential. An EHR system allows for quick and easy access to patient records and a rapid transfer of information from physician to pharmacy.

In the event of an emergency, quick access to records can make all the difference in a life-threatening situation; real-time access to records gives paramedics the ability to quickly and confidently learn the victim's medical history and identify any pre-existing conditions or allergies to medications. Moreover, by avoiding multiple entries, hospitals can increase efficiencies and streamline operations, allowing the focus to shift from heavy clerical tasks to more mission-critical tasks.

Another important benefit to mention is the financial advantage to hospitals and healthcare institutions. The maximum amount of funds will be available to hospitals that put an EHR system into practice within the first three payout years (2011-2013), and the funds thereafter will decrease by 25 percent year over year until the funding is no longer available. So, making an early switch to EHR is financially smart and can also help hospitals avoid looming penalties in the form of decreased Medicare and Medicaid reimbursement.

Moreover, these systems keep institutions competitive in another, often overlooked, way--through talent recruitment and retention. For newly minted doctors who grew up in the Internet age, working at a technology-savvy institution with modern communications is a draw. Quite simply, the best talent wants the best tools.

All that said, carrying out an EHR transformation is a lengthy process. In fact, it takes anywhere from two to three years to complete, depending on where the organization is in the transition process. With the first stimulus payouts scheduled for 2011, beginning the transition now is critical in order to ensure the proper steps are completed in time to realize maximum fund benefits and avoid penalties.

Through a six-step process, a hospital can gauge where it stands in the transition to an EHR system and it looks something like this:

1. Assessment: The first step to a flawless transition is an assessment of the existing infrastructure and data to determine its quantity, quality and age. Patient records must be consistent throughout the hospital in order to transition to an EHR system.

2. Definition of future state: Once the initial assessment is complete, the hospital must define its future state. This definition will encompass best practices in EHR, available hardware and software, trends in EHR, and the current state of technology in the hospital. 

3. Gap Analysis: The gaps between today's environment and the future state are defined and documented. Gaps include data quality and format, hardware and software gaps, and required business process changes.

4. Strategy to "close the gap": At this point, a written strategy is developed to close the gaps by first determining an order of priorities, and then the necessary hardware, software and man power required to apply these initiatives.

5. Business Case: Once a strategic plan is in place, the next step is to build and sell a business case that includes costs, time needed for completion, long-term payback and any other advantages or disadvantages to be realized through the implementation.

6. Implementation: Lastly, the longest and most challenging step is upgrading from the current system to the electronic system, which involves installing both the technical specifications of the envisioned system as well as the business processes to enable the desired shift. This stage includes data corrections, vendor analysis, hardware and software implementation, and business process changes.

With the first of the stimulus payouts not far down the road, the quickest to the gates will draw the greatest benefit. The longer a hospital waits to begin EHR implementation, the more it will lose its competitiveness. Competitors will gain an edge from a technology standpoint and collect the maximum stimulus funds.

Tom Pettibone, founder and managing partner of Transition Partners, is an expert source on IT budget management, CIO advisory, capitalization of investment, and IT value, which is a growing concern given the current economic situation. He is a senior executive with more than 25 years of experience in Information Technology line-management and management consulting, and an expert in achieving IT turnarounds in small and large companies, aligning IT and business strategy, implementing IT for new business capability and achieving bottom-line improvement.