Best Laid Plans

As we get nearer to implementation of EHR, we will become more aware of how difficult change can be. And change intended for the better sometimes makes things more difficult, at least at first.

Most likely our EHR will make some things safer and easier, such as health maintenance tracking or keeping medication lists updated, and other things harder such as documenting a complex visit. With planning and foresight we may prevent major disasters and anticipate the struggles. There is already an expectation, for example, that our efficiency will take a hit for months (6 to 12) after implementation, and that additional support staff hours will be budgeted for data entry and scanning as we move from paper to electronic records.

But sometimes despite planning, things don't go as intended. Just last week, TriCounty pulled the plug on the staff time-clock system, a web-based system that was intended to add efficiencies, but unfortunately had the opposite outcome. I do not know the details of that system or the decisions around it, but it is a cautionary tale for us as we move toward the far more daunting EHR launch.

Some likely lessons? Anticipate what could go wrong; listen to all the stakeholders; learn from other clinics who have done it before; keep the lines of communications open; keep the goals in sight; where necessary pull the plug!