Our healthcare system is currently undergoing a system wide implementation of an ambulatory electronic health record (EHR). The implementation includes current system upgrades to model experience and conversion to model across various hospitals and practice plans all of which have disparate EHRs. Since all ambulatory practices will be unified onto a single EHR with a single patient record, this implementation spans the entire continuum of patient care from pediatrics to geriatrics in all specialities. With this comes its own set of challenges as each specialty has its own set of requirements and regulatory obligations as well as well defined workflows. It is well known that any successful EHR implementation involves physician engagement and when this is to be achieved across the entire spectrum of medical care, poses its own set of challenges. How does one reach a consensus on decisions that will impact every physician, and in this case thousands, in your healthcare system? The reality of a go-live event is that you only have one chance to get it right.
My question at this stage of the implementation process is that go-live is likely at least one year away, but in the interim foundational type of decisions. How does one achieve consensus amongst a diverse group of physicians all with different clinical needs and wants on system wide decisions? How can you keep this diverse group engaged in what is likely a long and intense process, and at times somewhat abstract? Once decisions are made there is often no testing ground to investigate the impact of that EHR change in a real life scenario.
I would be interested to get feedback from my peers on your experiences with EHR implementations.