Curbside Consult with Dr. Jayne 1/11/16

Even though I haven’t been their CMIO in some time, my former employer continues to include me on many of the communications as they move forward with their migration to a single EHR platform. They just sent out a “year in review” listing some project highlights.

Although we were always strapped for staff, they’ve mysteriously found the budget to bring on more than 300 positions, the majority of which are incremental additions. I shudder to think of what we could have done with the “old” platform if we had even five more staffers. It always felt like we were holding things together with bubblegum, baling wire, and duct tape. The software was often blamed for problems that were, more often than not, due to our implementation or processes.

They also listed how many hundred hours of training, design, and decision sessions have occurred. Again, I know that had we been able to pull people away from their daily work, we could have made a tremendous difference in their user experience as well as in patient care.

Leadership appears to be on board, but I wonder if it’s because they really believe in the project or whether it’s because they know it’s a substantial financial commitment and they have to be on board. Maybe it’s also the “me too” effect since we’re the last health system in the region to move to a single product platform.

I was amused by their back-slapping about being on a single “seamless” record because they seem to be overlooking the fact that they carved out the lab systems and the revenue cycle systems. Of course they’ll be interfaced, but that’s not always what it’s cracked up to be.

I was surprised though to read that they’re going to allow the platform to be hosted outside of their corporate data centers. The mere idea of hosting anything externally was enough to make them cringe when we brought up our HIE the better part of a decade ago. I still remember making the rounds trying to twist people’s arms since I knew that independent hosting was the only way to get the community-based physicians on board.

Although they’re consolidating clinical applications, they’re bringing several new vendors into the fold. I’m not surprised since they tend to come along with some of the big-name systems these days. They provided a detailed list of what they’re keeping and will integrate with the new system and it was significantly larger than I expected.

There are whole hospital departments that will keep their same software, although it will interface to the central EHR. In some areas, the physicians will keep documentation in an external system but the nursing staff will document in the new system, which although likely intended to keep the physicians happy, feels a bit like a recipe for disaster.

Not two emails later, I received notice of the monthly fixes to the inpatient application that was written in a new format (probably in honor of the new year) that was extremely difficult to read. If you have to use multicolored highlighter on every single item, you’re probably not writing clearly enough for your audience. The amount of color on the document was enough to make my head spin. For a few moments I contemplated sending them back a user interface document on effective and appropriate use of color, but figured that I’d much rather them not know I’m reading so I can continue to play along with the home game and not risk being removed from the distribution list.

Although the EHR consolidation project is at the top of the scale for visibility, promotion, and funding, I’ve heard there are rough waters ahead. There may be an impending shakeup in the clinical leadership and possibly in the IT leadership as well.

It wouldn’t be the first CIO that we’ve seen sign up for a major initiative like this and then step out the door, although usually there are cost overruns or delays first. Maybe the CIO in question was planning to use this endeavor as his swan song all along – it’s hard to tell sometimes. I’m putting money on the fact that he won’t until go-live, though.

Reading all the updates reminded me of how much I miss the CMIO role. Being a consultant definitely isn’t easy and the travel isn’t glamorous, fun, or sometimes even tolerable. However, it’s been a great way to see under the covers of dozens of hospitals and health systems and to learn in a way that I would not have been able to had I stayed in my previous role.

Unlike Mr. H (who just got his Global Entry), I may be ready to put my rolling luggage in the closet permanently. I’ve decided to hold on accepting new clients while I consider going back on the market as a CMIO. Spring is just around the corner and I’m ready for some new growth.

Who else is planning to job hunt at HIMSS? Email me.

Email Dr. Jayne.