Saturday, August 1, 2009

Formal entry into CMIO blogging

Okay...

I realized, after I posted a bunch of stuff on Twitter this week, that people actually read what I posted.

As in, they asked me to make some sense of the chaos that I posted, because people were curious if I had any tips about good EMR implementation.

It was then that I decided I needed to actually start to write something a little better organized. So I'll try writing more on this blog - Mainly, for those of you who want/need a CMIO, but don't have one yet - I'll try to give you the little tips and tricks that I think can help a hospital have a good EMR implementation.

My little pithy blog is no substitute for an actual CMIO in your hospital, but until then, you'll have to read on.

Now, without further delay, my EDITED list of tips for good EMR implementation :

#CMIO tip #1 for DOCS wanting to fit into the new #EMR paradigm WELL: Learn to type, even a little, or learn to use Dragon well. Your thoughts are too important to be lost to handwriting.
#CMIO tip #2 for DOCS wanting to fit into the new #EMR paradigm WELL: prepare to redesign yourself. You won't be Dr. Kildare or Dr. Welby or Dr. Auslander or Dr. Dorian or Dr. McDreamy when you're done -
You'll be a whole new doctor. Same look, same skills, same caring, same name, new doctor.
#CMIO tip #3 for successful #EMR implementation : the EMR isn't "an IT thing", or an "MD thing", or a "RN thing" - it's everybody's thing.
#CMIO tip #4 for successful #EMR adoption : Patience, part II: Like humans, no product is perfect. You will always question if you made the right choice. The truth : it probably was.
#CMIO tip #5 for successful #EMR adoption : Patience. Realize that government, vendors, docs, administrators, and patients are "still trying to figure it all out"
#CMIO Tip #6 for a successful #EMR implementation : Persistence. Never stop pruning, weeding, and gardening. Have a good gardening team.
#CMIO Tip #7 for successful #EMR implementation : Learn that no doc, nurse, pharmacist, administrator, IT person, or consultant knows the whole story. You need them all to work together before you'll understand.
#CMIO tip #8 for a successful #EMR implementation : plan your budget well. Then increase your budget for training and support.
#CMIO tip #9 for a successful #EMR implementation : Plan your data needs for go-live. Then prepare for them to increase exponentially after go-live.
#CMIO tip #10 for a successful EMR implementation : Break down the wall between IT and clinical worlds. Promote both sides together.
#CMIO tip #11 for a successful EMR implementation : Prepare to cringe every time you hear "Why can't we just _____?" Generally this is NEVER the answer.
#CMIO tip #12 for a successful EMR implementation : Plan for docs in the middle ground. Aim for happy mediums. Walk before you run.
#CMIO tip #13 for a successful EMR implementation : don't just plan for your inpatient docs, plan for your outpatient docs EARLY. Doing this well can be strategic as long as you stay within Stark laws.
#CMIO tip #14 for a successful EMR implementation : Leave your emotions and personal baggage at the door when redesigning clinical workflows. Focus on good patient care.
#CMIO tip #15 for a successful EMR implementation : Recognize the tribal culture of medicine, but don't be limited by it.
#CMIO Tip #16 for a successful EMR implementation : try to avoid the four-letter word : "INTERFACE". Use only when absolutely needed.
#CMIO tip #17 for a successful EMR implementation : Plan staffing for an initial reduction in efficiency. Develop measurable metrics.
#CMIO tip #18 for a successful EMR implementation : be prepared for more training AFTER go-live.
#CMIO tip #19 for a successful EMR implementation : Have a politically neutral, teambuilding, personable, persuasive, and creative CMIO.
#CMIO tip #20 for successful EMR implementation : Dont be discouraged. Even a flat #CPOE rate will respond to nurturing and TLC.
#CMIO tip #21 for a successful EMR implementation : make sure you work on building allies early, before purchasing software.
#CMIO tip #22 for a successful EMR implementation : The secret to physician involvement - give them a chance. A good CMIO will help.
#CMIO Tip #23 for a successful EMR implementation : Grow a crop of clinical "Jedis" who KNOW your clinical workflows,can help bargain and teach them, and help reinforce good IT behaviors. (Clinical "Jedis" : they're not just superusers. They investigate workflows and datamine. They're your best management consultants.)
#CMIO: Tip #24 for a successful EMR implementation : work hard to make a comfortable environment for change. Bad blood slows progress.

5 comments:

Paul Roemer said...

Welcome to the land down under. Excellent list

AeliaUSA said...

Great post. It is missing few tips from your big list. Anyway, it is still very good to see all tips in one place

Jonena said...

Dirk,
Great list! Any chance I can nudge you into also posting your blog entries on the Member Blogs Discussions on the EMR/EHR/PHR Clinical Transformation Group?

Dirk Stanley said...

What tips am I missing from the "Big List" - I thought I compiled it all...
Feel free to email me what I missed, I'll try to assemble them all together.

Rich Berning, MD said...

Thanks for starting a blog. I follow your comments on Twitter (need to get them to display here too...) but now you can really flush out your ideas.

Excellent tips. As a doc trying to learn HIT, I agree with your points but am focusing on the "patience, team work, and be-a-self-learner" tips especially.
Rich B