Achieving Value After EHR...
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Beyond Implementation: Achieving Value After EHR Implementation April 15, 2015 Heather Haugen, PhD The Breakaway Group University of Colorado DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
Transcript of Achieving Value After EHR...
Beyond Implementation: Achieving Value After EHR Implementation
April 15, 2015 Heather Haugen, PhD The Breakaway Group University of Colorado
DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
Conflict of Interest
Heather Haugen, PhD
Has no real or apparent conflicts of interest to report.
© HIMSS 2015
Learning Objectives
1. Examine the difference between implementation and adoption.
2. Identify the most common challenges of adoption and optimization including developing the most effective strategies for overcoming them.
3. Apply the four drivers of EHR adoption to your organization.
An Introduction to the Benefits Realized for the Value of Health IT
S
T
E
P
S
Satisfaction If we can transform how we use EHRs, the patient will gain better access to their information and less redundancy in processes.
Treatment/Clinical Effective use of an EHR will decrease some medical errors and possibly improve other health outcomes.
Electronic Information/Data EHR adoption will ensure the data and reports are accurate and valuable in guiding us to improve quality of care.
Prevention and Patient Education The use of data from our EHRs can drive better adherence to evidence-based medicine and preventative care.
Savings Achieving a high level of adoption, quickly, allows the clinicians to get back to treating patients instead of struggling with the technology.
Healthcare IT Disruption!
¹ONC, 2013; © 2010 Healthcare Information and Management Systems Society
Basic EHR implementations tripled from 2009 to 2012¹
Comprehensive EHR implementations increased 6x from 2009 to 2012¹
2009 2012
44%
12%
2009 2012
17%
3%
+32% +14%
A Long-Term Commitment: Adoption is a Process, not an Event
Divorce Rates on the Rise
Healthcare organizations
replacing EHRs¹
EHR purchases that are replacements of
current system¹
Hospital executives dissatisfied with their
current EHR
¹2013 Black Book Rankings; ²Premier's spring 2014 Economic Outlook survey
17.0% 30.0% 30.0%
Understanding the Barriers To Adoption
Implementation is not adoption! Myopic attention on go live.
Leading adoption is often misdirected toward IT or the CIO.
Traditional training methods are ineffective and insufficient, mostly event-based.
Metrics, specifically adoption metrics, are non-existent.
Sustainment of EHR adoption, for the life of the application, is usually left to chance.
The Adoption Gap
Clinical Documentation
Testing and Imaging Results
Clinical Decision Support
Computerized Provider Order Entry
Survey of CHIME CIOs: Adoption defined as 75% of physicians using the functionality according to prescribed best practices
Installed
Physician Adoption
91%
55%
91%
96%
84%
41%
73%
44%
Implementation vs. Adoption Implementation Adoption
Emphasis Go-live (Event) Outcomes (Process)
Ownership Technical / IT Clinical / Executive
Success Criteria Technological Integrity Role-based Performance
Management Focus Project Milestones & Cost
Quality Of Care
Workflow Expectations Repair Redesign
Clinical Involvement Negligible–Short Term Critical–Long Term
End User Attitude Apathetic Or Prejudiced Adaptable
Metrics Project Milestones Outcomes
Training Design Demonstrate Feature Role-based Simulation
Sustainment Post Go Live Left To Chance Primary Management Focus
© 2010 Healthcare Information and Management Systems Society
Engaged Leadership
The insight, will and ability of leaders to correctly govern and continuously inspire the team to achieve the intended outcomes.
Having Engaged Leaders Is Unconditional
Leaders
Prioritize
Know Role
Set the Tone
Connect
Govern
Stay Engaged
Speed to Proficiency Clear understanding and knowledge of the new application, by role, FAST. The ability to use the application to provide care.
A Dramatic Paradigm Shift
Give Time Back for Patient Care
-66% -55% -53%
6mo
2mo
20h
9h
16h
7.5h
Training Schedule
Training Time (RNs)
Training Time (MDs)
16
93.9% 92.0% 94.0%
Overall simulation course completion for hospital staff
Overall simulation course completion
for providers
Practicum exam average score
for learners (role-based)
Ensure High Performance
Recommendations Develop role-specific learning
Use scenarios
Develop sandbox activities
Value “fast failure”
Create “bite-sized” learning
Reinforce with visual verification
Performance Metrics End-user adoption measured in terms that connect directly to the expected clinical and financial outcomes.
The Power of Data
Performance Metrics Proficiency assessments
Clinical outcomes
Quality and safety
Meaningful use
Financial outcomes
Productivity
Cost of ownership/maintenance
Recommendations
Measure proficiency first
Define clinical outcomes of interest
Share data early and often
Don’t forget about financial outcomes
Use data to drive process improvements
Capitalize on the competitive spirit of clinicians
Adoption Sustainment
A long-term focus on the people, processes, and evaluations to improve adoption over the lifecycle of the application.
The Tyranny of “Time” Adoption has a Lifecycle
Optimization
Fluency
Threshold Proficiency
Readiness Implementation Utilization Upgrades & Additions
Adoption
Recommendations
Identify the roles needed after go live
Define governance for sustainment
Design a process for updating learning materials
Annual or quarterly assessments–random is fine
Use peer networks
Programmatic Optimization
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Requires Multiple
Strategies
Foster Adoption
Acknowledge Successes
Identify Best Practices
Enhance Workflows
Streamline Applications
A Review of Benefits Realized for the Value of Health IT
S
T
E
P
S
Satisfaction If we can transform how we use EHRs, the patient will gain better access to their information and less redundancy in processes.
Treatment/Clinical Effective use of an EHR will decrease some medical errors and possibly improve other health outcomes.
Electronic Information/Data EHR adoption will ensure the data and reports are accurate and valuable in guiding us to improve quality of care.
Prevention and Patient Education The use of data from our EHRs can drive better adherence to evidence-based medicine and preventative care.
Savings Achieving a high level of adoption, quickly, allows the clinicians to get back to treating patients instead of struggling with the technology.
