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Healthcare IT Leadership Requires a Thick Skin

Scott Mace, for HealthLeaders Media, September 25, 2012

The letter brings fresh insight into the challenges this one system faces, challenges probably being faced by many other systems, only for whatever reason, it's all gone public in Contra Costa:

  • Since paper charts aren't available, clinicians are spending hours recreating "abstractions", summaries of medical histories, or are having to abstract them in real time during visits, further slowing care.
  • Unresolved processes not put in place at the time of go-live have to be integrated into the EMR.  
  • Huge amounts of work, such as nearly all discharge orders, have been shifted from medical assistants and nurses to providers.
  • While Epic recommended a particular reduction in expected patient load on providers during the transition, hospital leadership expects an accelerated return to normal workloads.
  • Some well-trained clinicians, known as super users, are having to return to normal duties, reducing their ability to help continue training others—a form of training particularly necessary with adoption of EMRs.

The list goes on and on.  Brenda Reilly, MD, chair of the department of emergency medicine, told county supervisors that one patient waited 40 hours to get a bed after the Epic go-live.

None of the new news stories included a comment from Roth, who I interviewed last month. I contacted her office again, requesting a new statement. Here is what she sent:

"We reduced workloads for medical staff when we went live with our electronic health records [system] to help support them during this transition. Based on staff feedback, patient rosters remain reduced, and we are committed to working collaboratively with staff to develop a longer term plan that allows us to continue to provide the highest quality care for those we serve. As with any electronic health record implementation, we knew it was only the beginning when we launched our EHR on July 1 and that this process would be ongoing. Our integrated health system presents both unique opportunities and hurdles.

Though the implementation process has been challenging, we have already seen benefits and are making progress. Many of the reported issues have been resolved and we are working aggressively on issues that remain. The EHR is one of many critical steps we are undertaking to ready our system for health reform, and we will continue to work side-by-side with frontline staff to meet these challenges and take these opportunities to transform and improve care."

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