One writes to seal knowledge in their brain. Me, April 2016
(Image from Making Computerized Provider Order Entry Work. 2013)
Working on my latest implementation I kept hearing about a methodology for #CPOE implementation. What was the most frustrating to me is I couldn’t find it anywhere. A successful methodology should be written down, clear, and easily obtain so the next time you have a major implementation of an electronic medical record, you don’t have to reinvent the wheel. If you’ve done this greater than 40 times it should be sealed in the brains of everyone. The only problem with that is in the intervening years many of the people have moved on to different roles, many more people have retired or they moved on to different organizations. So that the people that made up the principal team for implementation may not even be available anymore. Those that are left they remember only bits and pieces of their role and sometimes what they remember is not applicable in your current state.
Now with the new implementation the roles of all the players need to be clear prior to any kickoff meetings. If you plan on going to a new electronic medical record and if you plan on completing this in a 9 month time period, rapid implementation, your methodology really needs to be on point. Readiness Assessment, Governance Structures, Policy Implementation and Review, Key Roles Definition and accountabilities all need to be in place even more so then the change management as well as the project management. As a medical director, I had a role, but it was not made clear to me until it was almost too late. If you want to take on a greater role you have to be careful that you know what the roles ar of key players in an implementation so as not to overstep. You can’t rely on the inconsistent verbal statements and archived emails from six or eight years prior that I recieved. (So-Not-Cool.) I did not get a clear project plan, education plan, or implementation methodology until after the go live. The age of the large scale go live ir practically over, except the DOD EHR Modernization project and the Greenfield Implementations in the Middle East, this is the decade of realignment and optimization. So what methodologies are out there for general consumption and what should be modified? I will be exploring over the next few posts what I can actually find this active in the blogosphere as well as in the electronic instruction manuals. I will detail how clinical process improvement is as necessary to sucessful practice as passing the boards. I also plan on detailing how some slight changes and automating certain aspects of a providers workflow in its current state will improve efficiency and add to work life balance.