CEO Survival Guide - AHRQ National Resource Center; Health ...

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Executive SummaryElectronic health record (EHR) systems arean enabling foundation for healthcare—and organizational—reform. Investment inEHR systems makes possible significant,demonstrable improvements in efficiencyand productivity. Their potential to improvethe safety and effectiveness of healthcarecreates substantial—though more difficult toquantify—value. The benefit of investmentin EHR systems will only be fully realizedif these systems are interoperable—able toexchange data across providers, sites, andorganizations. The adoption of EHR systemsby healthcare providers would save anestimated $70 billion or more annually.Many efforts are underway in both thepublic and private sector to accelerate theadoption of EHR systems. The Health andHuman Services’ Office of the NationalCoordinator for Health Information Technologyis playing a lead role in establishingnational data standards to assure interoperability;and coordinating efforts to createregional, and eventually national, healthinformation networks for data exchange.Public and private purchasers arepursuing both “carrot and stick” approachesto encourage providers to invest in EHRsystems. Recognizing that providers bearmost of the financial burden of investing inEHR systems, but that many of the benefitsaccrue to purchasers or society as a whole,many purchasers have implemented pay-forperformancepayment programs that providefinancial rewards to providers who invest inhigh-value EHR system applications, and/orachieve safety and quality performance goals.Additionally, the pay-for-performance andaccompanying public reporting programs ofpurchasers impose significant data reportingburden on providers who do not have EHRsystems.Successful implementation of an EHRsystem requires sustained leadership. It is theCEO’s responsibility, with support from theboard of trustees, to articulate a new visionof patient care, and the role of EHR systemsin achieving the vision. Investing in an EHRsystem should be part of a broader strategyfor building a high performance health system.The EHR system is a powerful tool, but itis only a tool. Realizing the promise of thetechnology will require the redesign of clinicalcare processes and business practices.EHR system implementation is not all aboutinformation technology; it must be abouttransforming clinical and business practices.To maximize the likelihood of a smoothtransition to an EHR system, and to leveragethe full potential of the system, CEOs should:• Develop an enterprise-wide health informationtechnology (HIT) plan. A new vision ofpatient care should drive the HIT plan.The first investments should be insystems that can be built upon. Thewww.NQFExecutiveInstitute.org NQF Executive Institute 11
CEO Survival Guide to Electronic Health Record SystemsEHR system should be the single sourceof integrated patient information andconnectivity should be the foundationfor all specialized applications.• Cultivate sponsors. Successful implementationof an EHR system requires a seniorexecutive team consisting of a physicianchampion and strong clinical and administrativeleaders, in addition to the chiefinformation officer. The senior executiveteam will play a critical role in the strategydevelopment, sponsorship, organizationalpreparedness, financing, applicationselection, implementation, and ongoingmanagement of the EHR system.• Multi-year commitment and investmentstrategy. Initial capital investment inhardware and software is a small portionof the real cost of implementing an EHRsystem. The real costs to healthcareorganizations are in the training, workflowanalyses, short-term productivitylosses, and maintenance/upgrades to thesystem over time.• Application selection. Identifying keydecision makers and champions, developingcommon goals and functionality, andconducting site visits are the foundationfor application selection.• Ongoing management. Keys to effectiveongoing management of EHR systemsinclude strong and sustained leadership,open and extensive communication, rapidresponse to problems, ongoing training,reengineered work processes, updatedclinical decision-support, and realisticexpectations.EHR implementation is a leadershipchallenge. Together, healthcare executives,trustees, and physician champions mustcommunicate the need, reinforce the value,and assess the pace at which changes inpractice will be accepted in the clinicalculture of the organization. Realizing the fullpotential of EHR systems to contribute toimprovements in clinical care and efficiencycould take organizations 5 to 10 years.Strong executive and clinical leadership atall levels of the organization will be neededto “stay the course.”12 NQF Executive Institute www.NQFExecutiveInstitute.org
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ReferencesThompson TG, Brailer D. T
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