Hospital Impact: How to avoid IT conversion paralysis

EHR system
Implementing new technology in a health system can be overwhelming and costly while slowing productivity, but there are ways to make the process easier. (Getty/pandpstock001)

Many healthcare organizations have recently embarked on a process of implementing a major IT conversion. This can range from a new electronic health record to a new financial system to consolidating an electronic platform between hospitals and their owned physician practices.

Because of the complexity of a major IT conversion and the time and resources required, organizations can often fall into “IT conversion paralysis.” Although I certainly appreciate and understand the pressures of these projects, organizations cannot afford to put their operations on hold while they complete multiyear projects. The following information is offered as a guide to keep projects on schedule in an efficient manner so that the organization can continue to pursue other important priorities simultaneously.

Implementing new technology in a health system can be overwhelming and costly while slowing productivity. This checklist is intended to help evaluate your progress and determine if you’re on the right track or in need of assistance to achieve a successful transition.


  • Is the implementation pulling key staff away from important responsibilities?
  • Will the new system overwhelm doctors with documentation and reduce the number of patients they can see?


  • Have you experienced financial increases in the required funding above and beyond what was originally quoted?


  • Have you experienced delays achieving key milestones?
  • What impact do these delays have on the organization’s ability to pursue other priorities?


  • Would there be an advantage to having an implementation advocate address and be accountable for a successful implementation, including training?

Accuracy and completeness of implementation

  • Through mergers and acquisitions, data is often scattered. Are all data sources accounted for?
  • When you go live, how are you assured that systems will work correctly?
  • Are you concerned about losing revenue due to bills not getting out the door, collections (cash flow) and access to your EMR?

The answers to the questions on the checklist may inform you that an implementation advocate could be a useful technique to consider. An expert advocate can bring an unbiased, industrywide perspective to the project that should include the following:

  1. Forensics: Define goals, understand the culture and plan an approach.
  2. Benchmarking: Competitive analysis, find efficiencies and create new profit centers.
  3. Engineering: Uncover cash flow and profitability issues, and create new savings.
  4. Implementation: Align technology with culture, smooth transitions and produce immediate results.

Some organizations have an internal resource that can be used for this purpose. If that is the case, it is often effective for this person to be selected from an area or within a reporting structure that represents an unbiased evaluation of the project. It should be someone who has the authority to demand accountability and keep the project moving on time and within budget. Many organizations may not have this type of resource and will look to outside experts who can provide the unbiased project management and multiple-industry perspective needed to bring projects to completion in the most efficient manner possible.

Regardless of the approach, perhaps the most important goal is to require accountability of all key stakeholders both internal and external to complete the project on time, within budget and without disrupting ongoing operations.

Kevin L. Shrake is a 35-year veteran of healthcare, a fellow in the American College of Healthcare Executives and a former hospital CEO. He currently serves as the executive vice president and chief operating officer of MDR, based in Fresno, California.