Ten years ago, arguably the most famous fizzle in healthcare information technology history happened when Cedars-Sinai Medical Center in Los Angeles scrapped it's “big bang” implementation of a computerized physician-order entry system.
The much publicized failure
of a then-health IT leader sent a chill through the healthcare IT industry.
In March, the hospital completed a seven-phase, five-year effort to buy and roll out a commercial EHR system with a hospitalwide implementation of CPOE, said Darren Dworkin, its senior vice president of enterprise information systems and chief information officer.
Dworkin presented an opening-day educational session at the College of Healthcare Information Management Executives' 2012 Fall CIO Forum, “Implementing CPOE the Second Time Around,” which included 10 “lessons learned” from their experience.
“I think training is, hands down, the most important lesson,” Dworkin said. And overcoming resistance to training is essential to a successful training program. One aid to that effort was a video for Cedars staff that presented and demolished the argument that the computer system itself ought to be so intuitive that no training is necessary.
Unlike an iPhone, CPOE systems are “freaking complicated,” he said. “I think you can get away with” eight hours of training per user, but 20 hours is much better, he said, adding that Cedars users probably “picked up 20” with ongoing user support.
Another key to success is being able to say “no,” and putting someone in charge “that can say what you will do, but also what you won't do,” Dworkin said.
“Decide on a set of realistic goals and stay with them,” he said. That allows an organization to stick to an implementation plan. The Cedars motto was “install first, optimize later,” even when several good ideas—even financially rewarding ones—to improve the system were presented.
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