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Maximizing Your Quality Investment: Health Information Technology Adaption
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Maximizing Your Quality Investment-Health Information Technology Adoption
Heather Haugen, PhD | CEO and Professor
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Agenda
• The value of technology adoption to achieve outcomes
• Understanding the healthcare IT landscape: replacements, new technologies, and adoption challenges
• Examining how other healthcare organizations are achieving value from technology
• Recommendations for leading, educating, measuring and sustaining technology adoption
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Healthcare IT Disruption!
Basic EHR adoption increased 5x from
2009 to 2014¹
+47%
12%
59%
2009 2014
1Charles D, Gabriel M, Furukawa MF. “Adoption of Electronic Health Record Systems among U.S. Non-federal Acute Care Hospitals: 2008-2013,” ONC Data Brief, no. 16. Washington, DC: Office of the National Coordinator for Health Information Technology. May 2014.
+23%
26%
2009 2013
Comprehensive EHR implementations increased
8x from 2009 to 2013¹
3%
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The Adoption Gap
Adoption defined as 75% of physicians using the functionality according to prescribed best practices.
ClinicalDocumentation
Testing andImaging Results
Clinical DecisionSupport
ComputerizedProvider Order Entry
Installed
Physician Adoption
91%
55%
91%
96%
84%
41%
73%
44%
Survey of CHIME CIOs:
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Long-Term Commitment:Adoption is a Process, Not an Event
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Divorce Rates on the Rise
The number of buyers replacing existing EHR software hasincreased 59% since 2014.
Software Advice, EHR Software BuyerView 2015; http://www.softwareadvice.com/medical/buyerview/ehr-report-2015/
0% 10% 20% 30% 40% 50% 60% 70%
Q1 2015
Q1 2014
Q1 2013
Q1 2010
37%
48%
50%
63%
60%
40%
30%
20%
Replacing Commercial EHR Replacing Paper
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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.
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Engaged Leadership
The insight, will and ability of leaders to correctly govern and continuously inspire the team to achieve the intended outcomes.
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Recommendations
Clearly define ownership
Allow/expect governance to evolve
Require compliance
Influence and lead
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Speed to Proficiency
Clear understanding and knowledge of the new application, by role, FAST. The ability to use the application to provide care.
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Consistent Experience for All Users
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
45,000
50,000
1 3 5 7 9 11 13 15 17 19 21 23 25 27
Months
Users from January 2014 – March 2016
users
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A Dramatic Paradigm Shift
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95.0%88.0%
Ensure High Performance
Overall simulationcourse completion
for users
Practicum exam average score for learners
(role-based)
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Recommendations
Develop role-specific learning
Use scenarios
Develop sandbox activities
Value “fast failure”
Create “bite-sized” learning
Reinforce with visual verification
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Step on the Scale
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End-user adoption
measured in terms that
connect directly to the
expected clinical and
financial outcomes.
Performance Metrics
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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
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Adoption Sustainment
A long-term focus on the people, processes, and evaluations to improve adoption over the lifecycle of the application.
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The Tyranny of Time- Adoption has a Lifecycle
Optimization
Fluency
ThresholdProficiency
Readiness Implementation Utilization Upgrades &Additions
Adoption
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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
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What if we invest all this time and money in training our people and
they leave?
What if we don’t and they stay?