Tweet

Top Causes of EMR Implementation Failure

Guest post by: Peter Polack

Article Overview: About half of all IT projects fail. Very often, the root cause is the 'people factor.'

Top Causes of EMR Implementation Failure

Recently I met with some colleagues: physicians practicing Neurology & Family Practice, both of whom haven't yet gone to EMR. There are two main reasons for this: 1) They're not sure where to begin. Several of their friends have tried unsuccessfully to implement EMR at the practice. In most cases, it was a strong effort; some teams gave up in time, and yet others went down for the count. Some spent and lost money and time on the project, then calling for 'no more.'

2) The rate of failure among electronic medical records projects is estimated at between 30 and 50 percent. At first I was startled at this high rate. But, asking around you'll find someone who's had a bad experience, or someone who has. It's difficult to calculate a true failure rate, especially when determining the difference between abandonment - a stopping of use with the EMR system, or true failure - often reported by a software vendor.

Regardless of whether a situation is called an abandonment or a 'true' failure, there is the same result: Money, time, heartache, and a practice which falls back into using charts on paper exclusively.

The primary causes fall into a few major areas:

Lack of Commitment or Leadership

Is there a champion physician at your practice? Physician groups need to reach consensus and keep things moving, and without this the smallest bump can have serious repercussions. The champion need not become an enthusiastic proponent of EMR, but they must buy in with the project. Once a staff starts to sense a lack of unity among the level above, things may begin to break down, with splits into different camps, either pro- or anti- EMR. Ultimately, if the project fails, the entire team fails - not just the single person who initially championed the cause. There's the chance of a mutiny spreading among the group. There could be a single physician or staff member who is purposefully thwarting the project. They could be spreading doubt among the neutral, or attempting to escalate problem situations. The champion must discover and re-organize these influences before they travel too far into the organization. The champion also must be sure that communication lines are working, with scheduled meetings before and following a date to go live, so a system can quickly be set straight before a particular user gets frustrated and gives up.

Bad Planning & Implementation

This category covers the entire gamut, from hardware and software issues, to setup design, and on to roll-out implementation. Either an IT staff person should be on-board, or an outsourced technology consulting firm should be involved in both planning and implementation. This could include planning, planning training, as well as the product design, and implementation stages. A dynamic schedule or another work breakdown structure should be in place, to keep things on track. A simulation day is another true test. Together these components nurture success, especially in a crisis. Expect to have at least one.

The Internet Technology advisor is also able to assist with network hardware purchases, while trying to control the overall costs of the system. Of course, that doesn't recommend buying the cheap stuff, either. Controlling the costs of physical infrastructure can turn on you in the end. Unless your office is small, consumer equipment available in retail stores may not be advisable. Obtain and keep up with service and maintenance agreements, including backup switchers and servers. Failure to do so could reduce your practice's effort.

Having no Purpose

Some electronic medical records projects are in trouble from the very beginning. If the goals for the future system are not described or understood, the chances that a successful plan can form is low. Unrealistic expectations and unclear objectives further reduce the chances of success. Often, practices which don't maintain a clear understanding of the situation or fail to get expert help could have avoided the problem of no purpose. What do you want the EMR system to do? If you're not sure of what you ultimately want, you won't be able to understand what the EMR system needs. If you're swept up into some software system at a meeting at the Academy, but without understanding the product or company first.

Change Management Problems

Ask any expert dealing with implementation of major technology projects. No matter which industry or business area, they all talk about the 'people factor' as being a top cause of project failure. Electronic medical records isn't any different. Many new doctors have grown with technology, having even trained with institutions already using an EMR system. They won't skip a beat. The same is true of younger staff members accustomed to social networking and texting. But some of the older physicians make have to make a greater adjustment. They may even have only recently using the Internet, or suffer from technophobia. The resistance to technology can appear in many ways, including refusal and withdrawal. Providing proper training for these employees, preferably by their co-workers, is key in preventing a learning curve that is too steep to be accomplished in advance of the day to go live.

Some of the older staff members could need substantial training. A process should identify those who are falling behind, requiring more re-training. Your practice can't afford to lack critical buy-in from staff or a lack of ready skill that's necessary to implement a project successfully.

Workflow processes are also involved in change management. Inefficiencies in care of patients will only be exacerbated on a digital platform. The go-live date is not the date to discover that the new EMR system doesn't live up to the way they've always done it before. Proper technical planning can also help ensure there is proper ‘fit' between the practice needs and the EMR solution. This can mitigate such failure factors as unrealistic expectations about the time it will take to get the EMR working properly, loss of productivity in the clinic, and inadequate customization. All of these can lead to abandonment of the software system and in a perpetual search for the ‘perfect' EMR solution which is never realized.

Related Articles
  Avert a Mutiny
  Business Plan Why Doesnt Your Business Plan Consistently Deliver Your Desired Results
  Consultative Selling Addresses the Need Buyers Never Admit
  Increasing Marketing Supplier Performance Through Business Strategy Alignment
  5.2 Structure for implementing the SME Development Policy: Support for Growth-oriented Women Entrepreneurs in Tanzania, 2005

Article Tags: abandonment, bad experience, bump, champion, colleagues, consensus, electronic medical records, emr system, enthusiastic proponent, entire team, failure rate, family practice, heartache, money time, mutiny, physician groups, repercussions, software vendor, splits, staff member



Related Forum Posts
Why A Project Fails? - Hello Everyone As the size and complexity of ones business grows, so does their need to effectively manage projects. I have been thinking about the major reasons why a project can go wrong and my limited experience comes up with the following. 1 Leadership: A project manager with leadership skills and not just management skills. 2 Failure to (Foresee and) Plan 3 Failure to Manage: Ineffective change management control methods. Unclear decision making guidelines. 4 Talent: Finding, allocating and developing people 5 Scope: Setting an overly ambitious or amibigious project scope 6 Alignment: When projects are not prioritized in alignment with the business strategy, or project members personal objectives are not in tandem with that of the project / company 7 Lack of Candor: Communication Breakdowns I would be interested in knowing everyone's thoughts on this, especially on ways to overcome the above mentioned obstacles. Cheers!
Top performing Franchise Loans - Evan, There are over 120 Franchises listed by the SBA with 0% Loan Failure from 10-1-00 to 9-30-05 these companies have at leat 10 loans disbursed. A number of the companies are Hotel/Motel Franchises so I listed them separately. Since all the ones listed have 0% loan failure I listed them descending by # of loans disbursed. Top 20 (by # loans Disbursed) 0% SBA Loan Failure (does not include hotels/motels) 1 21425--CULVER'S FROZEN CUSTARD 85 2 66910--PRIMROSE SCHOOL (DAYCARE) 76 3 14467--CARTRIDGE WORLD STORES 54 4 68021--QUIZNO'S SUBS 41 5 06560--AUNTIE ANN'S (SOFT PRETZELS) 40 6 29912--FIREHOUSE SUBS 35 7 31154--FOOT SOLUTIONS 35 8 52707--MEDICAP PHARMACY 35 9 09802--BEN & JERRY'S ICE CREAM 33 10 67759--COMFORT SUITES 33 11 70150--RITTER'S FROZEN CUSTARD 32 12 05650--ARBY'S 31 13 65160--PLATO'S CLOSET 31 14 67417--PUMP IT UP 30 15 69149--REMAX 30 16 71456--SALAD WORKS, INC. 30 17 76282--SONIC DRIVE-IN 27 18 84725--UNION 76 OIL 27 19 17049--CHRISTIAN BROTHERS AUTOMOTIVE 26 20 78950--SUNOCO SERVICE STATION 26 Top 10 0% SBA Loan Failure Hotel/Motels 1 10275--BEST WESTERN INN 104 2 67750--COMFORT INN 98 3 38605--HOLIDAY INN EXPRESS 87 4 36680--HAMPTON INNS 57 5 53165--MICROTEL 33 6 75385--SLEEP INN MOTEL 26 7 04160--AMERIHOST INN 18 8 69134--RED ROOF INN 13 9 17230--CLARION INN & SUITES 11 10 20715--COUNTRY INN 11
These maybe the coldest franchises out there: - Here are the worst 15 performing franchises in regards to having the highest Small Business Administration (SBA) loan failure rates. The list is dotted with sub sandwich shops, fitness centers and car shops. WORST FRANCHISE LOAN FAILURES Failure % 1 OBEE'S SOUP SALAD SUBS 55.56% 2 LADY OF AMERICA 41.94% 3 COUNTRY CLUTTER (BED & BREAKFAST) 41.18% 4 COPY CLUB 36.36% 5 ALL TUNE AND LUBE 35.71% 6 PICKERMAN'S 35.71% 7 PHILLY CONNECTION 35.59% 8 ROLY POLY ROLLED SANDWICHES 34.78% 9 COTTMAN TRANSMISSION 34.48% 10 HAIR COLOR EXPRESS 33.33% 11 LEE MYLES AUTOMOTIVE TRANSMISSIONS 33.33% 12 GODFATHER'S PIZZA 33.33% 13 SMOOTHIE FACTORY 33.33% 14 BLIMPIE 31.39% 15 GOLF U.S.A. (RETAIL GOLF EQUIP.) 30.77% Source: Small Business Administration, SBA Loan Performance Within Franchise Code for the Period of FY 2001 - 2005
Manufacture of POTATO Flour / POTATO Powder - Manufacture of POTATO Flour / POTATO Powder About Project Setting up of a unit for manufacture of potato powder About Product and its use: Potato powder is increasingly being used in a variety of food preparations like snack foods (Mc Donald, Pringle, Haldiram namkeens etc.), soups, curries and other dishes as a thickening agent. Its use at present is mainly in hotels, restaurants, but acceptance in household is growing due to its inclusion in items like ready to cook soups, dals, curries, etc. Market Potential: The potato powder is supplied in bulk to the manufacturers of the various snack food items and restaurants/ hotels. The major demand is in cities like Mumbai, Delhi , Chennai, Nagpur , etc. The demand is much more than the supply at present and is likely to grow with the increasing popularity of the snack foods and other items where potato powder is used as input. There is good potential for its export also. Production process and technology: Procurement of potato -> Washing -> Cooking -> Pulping -> Drum drying -> Potato Powder -> Packaging -> Marketing The plant and machinery can be used for producing other products like fruit powder, tomato powder, etc. Key risk factors: Availability of adequate quantity of suitable chip varieties, which are used for powder making (like Kufri Jyoti, Kufri Chipsona) is the major factor which could affect the project. Availability of alternatives to potato powder for thickening like tapioca, corn starch etc., could affect the market of potato powder adversely. However at present there is no problem Quality control and Statutory Requirements The unit need to obtain a licence under FPO 1955 from the Ministry of Food Processing Industry Clearance from State Pollution Control Board Capacity of processing raw material (potato): a) Indigenous technology - 32 MT/ day of potato for 90 days per annum. b) Imported technology - 96 MT/ day of potato for 90 days Capacity utilisation is assumed on 90 days basis as the storage facilities for these varieties are not commonly available. However, capacity utilisation can be increased if the existing cold storages are modified suitably with an additional investment of about Rs 2000/ MT. Potato powder recovery: 17% of the raw material. Cost of raw material (potato): Rs 2500 per MT, Sale price of powder: Rs. 55000/ MT. Manpower requirement: a) Indigenous technology: Skilled and trained - 2 Nos; Unskilled - 3 Nos b) Imported technology: Technical - 2 Nos; Skilled - 2 Nos; Semi-skilled - 3 Nos. Power requirement: a) Indigenous technology: 40 HP b) Imported technology: 60 HP Water requirement: a) Indigenous technology: 1,50,000 litres per day. b) Imported technology: 5,00,000 litres per day. Contact Us for FULL Project Report and Project Implementation Consultancy alphabeta24365@yahoo.com


Share this article with your friends. Fund someone's dream.

Leave a comment below or share on the left and you'll help support entrepreneurs in Africa through our partnership with Kiva. Over $50,000 raised and counting - Please keep sharing! Learn more.

Tweet

Newsletter

Get advice & tips from famous business
owners, new articles by entrepreneur
experts, my latest website updates, &
special sneak peaks at what's to come!

Name:
Email:

Popular Articles

Improve E-mail: Avoid the Quicksand

Local Marketing: 3 Simple Low-Cost Strategies

The Biggest Domain Name Myth

Suggestions

Email us your ideas on how to make our
website more valuable! Thank you Sharon
from Toronto Salsa Lessons / Classes for
your suggestions to make the newsletter
look like the website and profile younger
entrepreneurs like Jennifer Lopez.