Healthcare News & Insights

4 mistakes that lead to EHR disasters

In addition to choosing the right EHR system, it’s also important to properly plan the installation and adoption of that software. Here are some lessons learned from real-life EHR implementation disasters. 

115029066One of the most publicized EHR installations gone wrong occurred earlier this year at Maine Medical Center in Portland, ME.

Four months after beginning a rollout of a new EHR system, the hospital’s CIO left the organization, and the hospital announced a hiring freeze, according to Healthcare IT News.

Those changes and other cost-saving measures came about after the hospital lost a reported $13.4 million over six months. Trouble with the EHR implementation was cited as one of three main factors, along with a decline in patient volume and an increase in patients who couldn’t afford to pay for their care.

1. Lack of training

One of the biggest issues that appeared when Maine Medical Center started using the new system: Charges weren’t being collected for many major services.

The hospital discovered the problem was largely due to a lack of training. Officials said nurses and doctors were never taught how to properly enter charges into the system.

According to reports, most of the training for clinicians was conducted by a select group of nurses who were trained to use the system and then sent back to teach their peers. The end result: No one was properly taught how to use the system and many people’s questions weren’t answered.

How much EHR training is necessary? That depends on the organization and the staff members who will be using the software, but one lesson should be clear: An EHR system shouldn’t go live until everyone knows how to use it.

2. Lack of buy-in

In addition to making sure everyone knows how to use the EHR system, it’s important that all users understand the benefits of the software.

Otherwise, doctors, nurses and others may not be using the technology as effectively as possible — and they may not even use it at all.

That’s what happened at Affinity Medical Center in Massillon, OH, in June, when nurses demanded that a planned EHR implementation be delayed. The nurses claimed they weren’t ready to begin working with the system, arguing that:

  • They didn’t get enough training for the system
  • The hospital didn’t have enough staff to manage the system, and
  • Nurses’ input was never sought when the system was chosen.

The last point is key, according to many experts. One way to get clinicians on board with using an electronic record system is to get them involved when choosing software.

That’ll make sure the system meets everyone’s needs as best as possible, and give those groups more of a stake in the implementation.

3. Going in pieces

When considering a big software installation, once tactic many organizations consider is a gradual rollout with different parts of the system going live at different times. That can help providers fix problems gradually as they occur without suffering a lot of issues all at the same time.

But that strategy can also create another problematic situation: having some staff members use a new EHR system while others continue working with paper charts or older software. That can create confusion and serious hiccups when the two groups must interact.

That’s the lesson learned in a story recounted by Paul Stinson of health IT vendor Emdeon about a 10-physician practice that wasn’t prepared for the problems that would come up when some doctors used the EHR and others didn’t.

Hospitals can still go with a staged approach by beginning to use different functions of the EHR system at different times. But most experts agree it’s important to have the whole organization on the same page at any given time.

4. Putting old records out of reach

When hospitals move to electronic records for the first time, one question many hospitals have is: What should we do with existing paper records?

St. John’s Clinic in Springfield, MO, decided it would only input the most recent information into the EHR system. The paper charts were later sent to a third party for storage.

That’s when problems started occurring. Doctors kept requesting old charts, which meant calling the third party and getting the information faxed over. That happened much more often than the organization was expecting, and eventually the clinic decided to scan the charts into the EHR system.

Converting paper charts to electronic records can significantly add to the costs of implementing an EHR system, but preventing doctors from accessing the information they need to treat patients can create a lot of problems.

What’s the best way to deal with old charts? The most popular strategies include:

  • Using in-house staff to scan all records into the system
  • Hiring an outside firm to scan the documents, and
  • Keeping the paper records and scanning them when the patient visits.

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