It looks like Dean F. Sittig, Ph.D., in his estimable Informatics Review, has really found a good one this time!
Informatics Review - Nov 15, 2007 : Vol.10 No.22
Mr. HIStalk's universal rules for big EMR rollouts
In case you haven't heard of Mr. HIStalk, here's a link to his blog illustrating his uncanny ability to succinctly say exactly what we all think and are afraid will slip out at the most inopportune time.
Universal Rule #8. You'll loudly demand that the vendor ship regular software upgrades to fix all the bug issues you submit, but then you'll refuse to apply them because you're scared of screwing something up with the skeleton maintenance staff you can afford, given that millions were spent on systems with nothing left for additional IT support staff or training.
Continue reading the other finds at:
http://www.informatics-review.com/
This blog is really amazing and there is certainly the ring of truth in the following:
From HIT Insider: “Re: Sutter. Haven’t seen this article on Sutter Health wasting millions on its Epic installation yet.” Link. Sutter’s original estimate to install Epic in six hospitals: $150 million. Current estimate: $500 million and going up. Nearly $100 million for one hospital? Says they learned from Kaiser’s mistakes.
Mr. HIStalk’s universal rules for big EMR rollouts:
1. Your hospital will pledge to make major processes changes, vowing to “do it right” unlike all those rube hospitals that preceded you, but the executive-driven urgency to recoup the massive costs means the noble goals will change to just bringing the damn thing up fast, hopefully without killing patients in the process.
…..
3. Doctors won’t use it like you think, if at all, because hospitals are one of few organizations left that doctors can say ‘no’ to.
…..
5. All the executives who promised undying support to firmly hold the tiller through the inevitable choppy waters and who overrode all the clinician preferences in a frenzy of inflated self esteem will vanish without a trace at the first sign of trouble, like when scarce nurses or pharmacists threaten to leave or when the extent of the vendor’s exaggeration first sees the harsh light of day in some analyst’s cubicle.
6. It will take three times as long and twice the cost of your worst-case estimate.
7. You’ll pay a vendor millions for a software package consisting of standardized business rules, then argue bitterly that all of them need to be rewritten because your hospital is extra-special and has figured out the secrets that have eluded the vendor’s 100 similar customers. The end result, if the vendor capitulates, will be a system that looks exactly like the one you kicked out to buy theirs.
…..
10. No matter how unimpressive the final result toward patient care or cost, the EMR will be lauded far and wide as wonderful since the vitality of the HIT industry (vendors, CIOs, consultants, magazines, HIMSS, bloggers) requires an unwavering belief that IT spending alone will directly influence quality, even when nothing else changes.
For the full 10 rules (and a whole lot more) visit
http://histalk2.com/2007/11/15/news-111607/
None of this will surprise anyone who is familiar with the challenges of Hospital Information System planning and implementation and I think it is vital that these sort of rules be kept in mind to avoid extreme strategic overreach!
No one know better than I how hard all this is – to be warned is to be armed and to have an improved chance of success.
Weep and Enjoy!
David.
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