Most clinical systems integration effort that aren't working are being blocked by a single factor--people. It's not that we lack the technical expertise to bring disparate data sources together, but rather, that institutions are getting swamped by internal politics. Efforts that focus on technical excellence and cost-savings have a basis, but if they don't do much to deal with people factors, they're missing a critical issue.
The case of the VA/DoD health data merger may be an extreme example--both institutions are famed for their insular culture--but their problems with integrating health information are telling nonetheless. Little seems to have been done to align their goals and more importantly, their incentives for succeeding at the integration. My guess, in fact, is key staff members have plenty of incentives not to play ball, including but not limited to fears their job will get harder.
If your institution's health data initiative, such as an EMR, is about to roll out, are you confining your discussions to some senior operational managers? For example, while some laudable organizations take the time to train doctors, encourage them and empower them to use new EMR systems, it seems other organizations take a top down approach. My instinct is those who fail to bring doctors into consensus are the organization struggling to make their big investments in EMRs pay off.
Also, are you taking steps to educate and gain consensus from the less-prominent but important players (such as medical record clerks currently tending the paper records) to help them understand and even look forward to the next step? Are you educating floor nurses, rather than limiting discussions to your CNO? Such support and education can turn out to be clinically and personally important to everyone involved.
Readers, I don't mean to insult you. I know many of you are well aware of the need to train workers and win their wholehearted support. But in case your organization is one that hasn't taken these steps, I urge you to do so. After all, nobody wants an EMR on board that staffers don't want to use. - Anne
P.S. On September 12, we'll be holding an intriguing Webinar on the future of the retail clinic model. I encourage you to stop in--we're going to have the CEO of a retail clinic system and head of an integrated health system's retail clinic efforts. Should offer some worthwhile food for thought. Sign up today!