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Hospital Executives' Leadership Critical to EHR Implementation

The College of Healthcare Information Management Executives for HealthLeaders Media, September 13, 2010

Caregivers whose jobs will be affected by an EHR must see active involvement by senior executives, particularly the CEO, COO, CMO, CNO and chief quality officer (CQO), in the planning and conversion to a digital system. Without a high level of participation and leadership, front-line workers may perceive EHRs as an "of-the-moment" program and resent the change and increased workload it represents. A successful transition requires a workforce that participates in design and knows what to anticipate; those expectations must be set forth by the executive team.

"Remembering the maxim, 'Culture eats strategy for lunch,' the primary objective of the CEO and other senior leadership is to set the cultural tone," said Bill Spooner, CIO at Sharp Healthcare. "They must live the vision and position themselves as the executive sponsors."

To prepare the organization to work through the implementation process, the CEO and other senior executives must get involved in the early planning for EHRs, including the obvious steps of agreeing to a timeline, process and budget for the transition. In most organizations, the CIO takes the lead in developing these plans, with input from other executives.

For instance, budget projections should encompass all expenses that will be involved in the total cost of the project, including hardware, EHR and third-party software products, maintenance support, implementation build support, internal people resourcing, third-party medical vocabulary content, implementation build tools, training content and support, implementation go-live support, loss of productivity during the rollout, and technology infrastructure changes.

With approval from the full executive team, the CEO and other senior executives then need to get involved in the implementation process and otherwise reiterate support for the effort. A member of the executive team, or the team as a whole, can take on the role of project sponsor and assume responsibility for the success of the project, perhaps aligning senior management compensation incentives to ensure the success of the effort. Senior executives particularly need to enlist the support of CMOs and CNOs, and/or create CMIO and CNIO positions to interact with clinicians and gain their support.

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