When EHR Strategies Become Non-strategic

Do not mistake chaos for fluidity. Three gazillion dollars have been spent to date implementing EHRs — that’s a bunch of money followed by two zeroes. And the feds are still offering rebates. Just tear off the coupon on the back of the EHR system and mail it to CMS.

The speed at which the productivity of the clinical staff at hospitals where EHRs have been implemented is dropping is approaching the sound barrier. Even so, hospitals continue to implement EHRs, somehow assuaged in their belief that their hospital will not be burdened by lost productivity.

The EHR vendors warn that productivity may drop for an hour or two. What they do not say is that productivity will drop for an hour or two every hour or two.

Once your organization begins to fall down the rabbit hole, there is no way out of its wilderness of mirrors.

Healthcare IT strategy: is it really the misnomer it sometimes appears to be? Is your HIT strategy strategic or just another part of the rabbit hole? One way to find out is to ask the question about whether the implementation of your EHR is adding value to the organization. It seems that in most hospitals, EHRs have resulted in long-term productivity loss. If your implementation resulted in less than or no better productivity than it had prior to the implementation, you cannot possibly tell someone with a straight face that that was your plan all along.

“That was part of our HIT strategy; spend $100 million on an EHR even though we knew our productivity would drop.”

For those whose productivity has not dropped, it appears there is a direct correlation between the productivity gained and not using the EHR.

“That was part of our HIT strategy; spend one hundred million dollars on an EHR and not really use it. That way, we avoid the productivity loss.”

Not buying this? Perhaps it hits too close to home. But what if you read or heard about something like this?

Suppose Wal-Mart implements a new $100 million electronic point-of-sale system and that their reasoning for implementing it was to collect more information on every customer than what God knew about that person. The system takes a picture of what each customer is wearing, and through a program of analytics and business intelligence, it identifies the clothing worn by the customer and then is able to mail that person marketing information on similar clothes sold by Wal-Mart.

The point-of-sale system also secretly scans the customer’s fingerprints and uses that information to search for and record all of the other items the customer may have touched in the store. It also forces the sales clerk to compare the customer’s last 10 purchases at the store in order to recommend other items to purchase.

Using the new system, Wal-Mart can collect wonderful information, and can create even more impressive spreadsheets and PowerPoint slides. Unfortunately, using the new system means that instead of ringing up a customer’s order in four minutes, it now takes eight minutes. Cashiers are half as productive as they once were. Realizing this, the cashiers fake using the system.

Sounds silly, doesn’t it? What kind of an organization would actually spend that much money on a system and retrain all of their employees to use it if it was going to hurt them?