more likely it is to fail,” Trisha Greenhalgh,
MD, told healthcareitnews.com.
Electronic health records are often depicted as
the cornerstone of modern healthcare, yet the
projects are proving difficult to implement, said
Dr. Greenhalgh, the lead author on a 2009
University College of London study of healthcare IT.
Other researchers are reporting similar findings.
“As currently implemented, health IT has a
modest impact on process measures of quality,
but no impact on administrative efficiency or
overall costs,” writes David U. Himmelstein,
MD, the lead author of a 2009 study of computerization projects and outcomes at approximately
4,000 U.S. hospitals between 2003 and 2007.
“Predictions of cost savings and efficiency
improvements from the widespread adoption of
computers are premature at best,” he writes.
One of the reasons the projects are in critical
condition, he says, is that the systems are
designed to meet the needs of accountants and
managers—not everyday users.
“You spend $25 million on the system itself
and hire anywhere from a couple dozen to a
thousand people to run the system. And for doctors, generally, it increases time they spend
[inputting data],” Dr. Himmelstein said in an
interview with Computerworld.
ON THE MEND
Despite the grim diagnosis, it doesn’t mean the
projects are dead on arrival. Rather, it’s a wake-up
call to evaluate the project delivery approach to
ensure all stakeholders and end-users are on board
and committed to making the transition, says
Josef Spencer, site director at Grand River
Hospital, Kitchener, Ontario, Canada.
“Whenever you try to invoke change, there is
a certain amount of risk,” he says. “Electronic
health record implementations represent a signifi-
cant paradigm shift.”
Project teams have to consider all the needs of
end-users and how the rollout will impact process
flows throughout the organization.
When Mr. Spencer was working on an electronic
medical record project at East Jefferson General
Hospital in Metairie, Louisiana, USA, the system
>>PRIVATE PRACTICES
With the blitz of new electronic health records projects, some consumers and advocacy groups are demanding to know precisely how
all that ultra-personal medical information will be protected once it’s
floating around in cyberspace.
transitioned accountability for recording vital
signs from the chart nurse to the nurse’s assistant.
As part of the rollout, Mr. Spencer’s team evaluated
the computer literacy of the nurse’s assistants and
found 75 percent of them didn’t have even basic
skills. So before the rollout, they were all required
to take a keyboard course.
“You can’t make assumptions about where
your end-users are,” he says. If Mr. Spencer’s team
hadn’t done the evaluation and implemented a
training plan, the majority of the people wouldn’t
have been able to use the new system.
“If you want these projects to work you have
to get buy-in from across the organization, and
everyone’s concerns need to be communicated
and addressed,” he says. “IT alone cannot make
these projects a success.” —Sarah Fister Gale
