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.

Healthcare Informatics

(Pfft Pfft!) Is this mike on?

So here we are in 2009, the country is trying to go EMR... And yet, and yet, there still seems to be so much confusion.

It seems like there's little sweeping organization. Each doc wants custom interfaces, each hospital wants custom interfaces, each vendor wants custom protocols, patients are left with nobody to help organize the sweeping change.

The government wants to organize the sweeping change, but so far, the ARRA/HITECH act has left the industry with more and more questions. And in the confusion, vendors are seeing opportunities to make more money.

The sad part is, that docs are poorly organized. Just as the poor organization of docs led to the sweeping financial changes which are now hurting healthcare, this same lack of organization has led to an antiquated information system in healthcare.

I'm here to help change that. If you're a doc, and passionate about helping patients through better technology, we need to organize. AMIA and HIMSS are good places to start, but the first place to REALLY start is to change your heart. Medical school doesn't prepare you for technology. You embrace it, work as a team, and bring about the changes that no government organization can bring.

Whether you're an older doc or a newer doc, the hill is the same. It's up to you how fast you want to climb it.