I am going to leave the CPOE topic this week. But, it was a good week to point out that our industry is pursuing CPOE without the proper planning or evidence that it will improve patient safety. So, I will move to the other phrase maxing out the “hype meter.”
I have a new rule. I am forbidding anyone to discuss “Electronic Health Records” unless they can describe three clear expected benefits of an EHR system and how the EHR will accomplish that. Furthermore, “Going paperless” does not count as a benefit.
Luckily, we are pretty much past that phase at Affinity. Certainly at the executive level. I still have some others ask me when I am getting an Electronic Health Record. My standard response is: “You are not allowed to use that phrase.”
I see some CIOs pursuing Electronic Health Records without any vision regarding what they want to accomplish. This is usually in the form of a CIO sending an email to a CIO list-serve asking if anyone has a EHR RFP. There is so much wrong with that request I don’t know where to begin. It is like asking if anyone has a good recipe. Well, I have great recipe for a Green Bay Packer tailgate, but if your medical staff is expecting a 5-course meal you are both heading for disappointment.
I truly believe folks need to develop their own functional requirements. At least the core requirements. But, that should only take place once they have developed a common vision with the leadership and medical staff. Once you know what you are trying to accomplish, then you can decide what features/functions you will need.
We have put together an Electronic Health Record manifesto. I love it, but I love my own cooking. I will post it later in the week to continue the EHR theme.
Candid CIO 
Excellent post, Will (as usual). As I’ve mentioned on my blog before, there are companies like AC Group that have a lot of source materials that can be used to prepare functional requirements and RFPs. I totally agree with you that many CIOs are looking for the “easy way” out but I’m happy to see that there are more and more CIOs willing to do the hard work of expectations management to see a successful project through.
This may not be a proper post here, but why isn’t paperless an advantage? I am afraid that post IT people and hospital Execs are only looking at EHR/CPR as a clinician tool instead of an HIM Process Automation tool. You have to admit that a very fundamental goal of obtaining an EHR is simply to get “paperles” and you can’t deny the ROI on turnaround time and increased efficiencies. Can you?
I usually don’t leave comments on my own blog, but I do have to reply to the questions above regarding “paperless” as a goal of an EHR.
Our paper budget is about $10,000 a year. How long would it take to offset a $30M EHR investment at $10,000 per year?
If paperless is code for other business advantages that come through IT-enabled business process re-engineering (less staff, quicker turnaround times, shorter wait times, etc.). Then let’s refer to those as the project goals. Labelling these very important business benefits as “going paperless” only results in confusion regarding the true goals (which get lost too easily as it stands).
I can create a paperless EHR that consumes more time, is hardeer to use, worsens patient care and results in no business benefits whatsoever.
PS Ripley, I appreciate the post. This is the kind of candid debate I love.
Ok, now we are getting somewhere… I agree totally with your response related to stating “clear” objectives and not just going “paperless”. The confusion comes with purchasing CPR/CIS type tools because of pressure from physicians and/or Exec. suite at $30MM with overstated ROI when a document imaging & workflow or other tools and/or solutions (i.e. portal) could accomplish some of the basic “paperless” goals and have better and quicker ROI.