You said I stole the money. Sometimes it all depends on what you emphasize. For example, say the sentence aloud to a friend, and each time place the emphasis on a new word. You said I stole the money. Yousaid I stole the money. You said I stole the money. You said I stole the money. You said I stole the money. The meaning changes as you change your emphasis. You said I stole the money? You can even change it so that it reads like a question.
The same is true with providers and the level of success a firm has working with EHR. Where is your emphasis? If you believe there is a correlation between emphasis and spending, I bet we can prove your firm’s is much more closely aligned to technology than it is to process. What does technology address? Let’s list how deploying technology makes your firm better, or does it? Millions followed by millions more. Redesign the patient portal. Add EHR. Mine the data—heck, strip mine it. Show me the ROI. Isn’t that a lot of money to spend without a corresponding business justification? Then add in the fact that the productivity at many hospitals after implementing EHR is twenty percent below what it was prior to EHR. That does not not do much for the ROI.
The technology that is tossed at the problem reminds me of the scene from the “Wizard of Oz” when the Wizard instructs Dorothy and the others, “Pay no attention to the man behind the curtain.” When Toto pulls the curtain aside, we see a nibblet—I love that word—of a man standing in front of a technological marvel. What’s he doing? He’s trying to make an impression with smoke and mirrors, and he’s hoping nobody notices that the Great Oz is a phony, that his technology brings nothing to help them complete their mission.
From whose budget do these technology dollars usually come for EHR? IT. From the office of the CIO–the only department in the whole hospital which will not “use” the EHR. What did you get for those millions? Just asking.
Part of the problem with doing something worth doing on the EHR front is that it requires something you can’t touch, there’s no brochure for it, and you can’t plug it in. It’s process. It requires soft skills and the courage to change your firm’s emphasis. They won’t like doing it, but they will love the results.
I like the way you’ve painted the emphasis picture. I see where you’re going with emphasis.
What is missing however, is the entire picture. Any capital investment has a curve for its ROI.
Your post seems to make IT the bad guy. Is is fair to blame technology? Technology is neutral; no emotions, no direction. It is the people that are in charge of placing the emphasis to get the desired effect that can change the ‘sentence’. The words, the construct and sentence is technology. You can get the desired effect with the use of the words and emphasis.
You do rightly mention at the end that it is the ‘process’.
Interesting comment, perhaps I mis-wrote. I do not think IT is the bad guy. In fact, I think the problem is from the users not providing leadership and resources to drive the process redesign and the change management effort. IT can put it in, but when it doesn’t work, I think it has less to do with what IT did and more to do with what others didn’t do.
The big question then is, why does this happen when so much is at stake – high investment, healthcare improvement, cost control. Is it because there is no accountability or that there is just not enough knowledge, benchmarks, experience available to compare?
I think it comes down to leadership, the CIO and especially the C-suite. It often comes down to a lack of a real plan. Where it works it works well.