Tuesday, June 05, 2007

The Dog and Pony Show



Today's site visit was the reason why our organization went through the heartache and headache of rapid implementation of this upgrade.

Our organization has served as a primary reference site for the vendor for the past 3 years. We got our dog and pony show down to an art form with the previous version. The new upgrade required us to re-prepare all of our material. Much like preparing for a new class...

The group that came to visit us today is potentially the largest contract the vendor will win....if they can ever close the deal. This group has been holding committee meetings, working with consultants, arguing amongst themselves, and generally researching this EMR thing for over a year.

The message I walked away with after meeting with them today.... these people are scared to death. I know the feeling......

In preparation for the site visit, the visitors sent us an Excel spreadsheet with 100+ questions. After meeting with us, they made it clear that they intended to go back home and compare notes to make sure what we said was consistent.

They were a little disappointed that we weren't further along in the process. They were also disappointed that we did not have everything implemented yet.

The visiting Administrative Director for Medicine asked

So did you all change job descriptions and processes before or after you moved from paper to an electronic medical record.

I had to think about how to answer for a bit, then returned to him and said "The best roll-outs did both."

Major change is a process. It's good to plan and visualize exactly what needs to happen to optimize your new tool. But you will never truly "get it right" until after you bite the bullet and make the change.

There has to be a continual reevaluation of your workflow. And no fear to admitting that something flat out ain't working. Tweak it and try again.

The sales rep for the vendor had a more elegant way of describing this, but there seems to be 3 phases with any sort of EHR implementation or major upgrade.

- Phase 1: "How do I get this thing to do what I am currently doing with the least amount of change on my part?"

- Phase 2: "I didn't know I could do that!?!? How can I use some of the other spiffy tools attached to this thing?"

- Phase 3: "How can I optimize my practice using this thing?"

As much as we would like to rush it - you can't skip the phases. Otherwise, you've lost all but your early adopters.

This was not what the visitors wanted to hear. They wanted to hear that after the training - all becomes hunky dory and perfect. They wanted to hear that they would not have to change the way they work. They wanted to hear that people automatically jumped to phase 3 - that people automatically "got it."

At the end of the site visit, I overheard the vendor's sales rep muttering to the vendor's Chief Marketing Officer

They are definitely not making a decision anytime soon.

From what I can tell - the visitors have paralyzed themselves.

I'll be curious to hear what happens.....

-----------------------------------------------------------------------
Picture from Silk Road Camels. Just in case you ever need a trained camel to go with your dog and pony show.....

1 comment:

Wendy said...

Thanks, it is good to hear there is hope past the "phase 1" folks. We have been live (different vendor - Cerner) for 2 years and only our early adopters are just starting to hit Phase 2. :-) It is good to read your posts and hear that I am not alone in my pain.