Don’t think this will be easy no matter what system you choose. It can be scary and a little overwhelming to change how things have always been done, but your team can make it happen. Don’t discount the physicians despite concerns you might have about resistance; many, even those close to retirement have been great. Charting is better, and the system prompts help. |
Be very open to change; it’s hard but it’s worth it. It’s like labor: a wonderful baby at the end, but it will hurt a little. This kind of integration is hard, it’s huge, but if you can get through it, you’ll be so far ahead: The impact on the community will be huge. Many community hospitals (just a little bigger than CAHs) have succeeded; you will, too. |
| 11. Policy/Meaningful Use |
Get serious about MU compliance; know who on your staff will interpret all the rules and make sure the software will do it. Abide the spirit not just the letter of MU; know what a CMS audit would entail: At some CAHs they’re falling short on physicians using CPOE, and others are doing it for them. Don’t forget bureaucratic details. If your hospital is supposed to be reporting on something already (e.g. PECOS) but isn’t, it could cause problems in MU attesting and reimbursement. Investigate early in the process regarding what your state is capable of doing regarding public health data reporting and exchange. |
Understand the deadlines, dates and timelines for MU reporting; it’s a work stream. Learn what the reporting measures for MU are and why; some at CAHs understand these, but many staff do not understand that MU is designed to increase quality and decrease costs. Understand that even if you’re already reporting on some of the clinical quality measures prior to implementation (e.g. manually extracting from paper) you must collect it electronically to be compliant with MU. |
| 12. Clinician/Physician Buy-in /Ownership |
Getting physician buy-in can be a challenge, but as a CEO you must get it, and earlier is better than later. Otherwise, staff will wind up doing the physicians’ work for too long, and it puts a strain on the administrator-medical staff relationship. Involve a physician in building and optimizing the CPOE module, which is not only pragmatic, but it encourages the physician to become a champion. |
Strong-arm physicians or coach them, but the administrator cannot back down. Show physicians how the EHR will do something good for them (e.g. a quick way to look at allergies, vitals, home medications) before asking them to do something. Have a plan to understand the fears of and engage physicians: The CEO’s approach can be as simple as ‘“We have to do this, so let’s figure it out together. It will get better!” If there is an hospitalist at the CAH, ask her or him to be involved in the implementation since she or he is there all the time and will use the system all the time. Ensure that there is ownership of the EHR by all clinicians across the clinical infrastructure: They need to be the expert drivers because it’s their tool to manage and grow to best manage the way they want to practice. |
