EMR and Implementation Challenges

[Dr Suryanath Gudidevuni]

During recent conference "eHealth India 2008" at Delhi, India, one of the evolving theme was how to make clinicians use EMR.

I think this issue is universal. Since, we all are at various stages of initiating/implementing EMR, can we discuss and try to find out best methods of addressing implementation challeges including how to influence physician behaviour to use EMR.

This can take shape of good international guidelines.

[Dr Suryanath Gudidevuni]

Well said dear Dzokoto Simon Yao. I agree with you 100%. Once they are accepting the EMR concept / implementation, they need to be taken care by providing enough support initially so that they do not feel they are doing extra work / burdened.

Regards

Suryanath

[Syed Muzaffar Ali]

I have been working on EMR for couple of years, It do have some advantages and disadvantages

Advantages
1. Your data will be completley protected
2. You dont have to worry about paper work and store them for years- just filling the cabinates.
3. Easy to audit
4. Easy to keep track of Patients and their complete information from A-Z.
5. Easy to keep track of patients insurance information.
6. Easy to track your staff, who did what
etc

Disadvantages
1. The change management- I know its not wasy to change from paper charts to electronic charts, it requires lots of effort, cost.
2. The cost of software and hardware and maintaing is too high
3. Training of physicians and other staff.
What all it requires is cost and efforts

But once implemented and the physicians and other staff are trained its easy and hassel free, your work flow will be much easier you can finish your work more faster, see more patients, or go to home early.

Over all its great to have EMR, it really helps.

Regards
Syed

[Dr.Vishweshwara.R]

Dear Dr Gudidevuni,
The above topic was a burning issue in HMA-08 in Manila, Philippines,which i attended, health administrators from all over the world opined that making the consultant adopt to IT was the herculean task.
In Philippines they have resorted to post graduate students doing the job of EMR as part of their work , leaving the consultants free of the work.
currently i am working on implementation of HIS in chain of a corporate hospitals in south India according to me the following are the major challenges:
• Setting up right expectations from the management and users in the hospital
• Availability of accurate and exhaustive master data
• User training
• Acceptance and appreciation of computerisation by medical, paramedical and other healthcare specialists
• Quantifying Return on Investment(ROI) and Key performance indicators (KPI).
• The cost is high and the hospitals are not willing for high investment.
• Designer user friendly interfaces is a challenge by itself.
• Customization of the software according to the needs and practices of the hospital.
• Hospitals perceive IT as a low priority area and have only around 2to 3 percent of the total budget for IT.
• It is equally important that the right infrastructure in terms of right sizing, the servers and PCs, with good bandwidth network connectivity and clean power supply will go a long way in ensuring smooth and satisfactory implementation.
• Interoperability of the software systems .

regards,
Vish Ramachandran.

[Dr Suryanath Gudidevuni]

Hi Mr Ramachandran

Thank you for your response. Where are your working in South India. I am in Hyderabad at the moment. I agree with what you have said. However, i think, now people are looking at HIS and EMR as good investment lately. Can you eloborate your following statement

Quantifying Return on Investment(ROI) and Key performance indicators (KPI).

I have done some work toeards that and and want to match your your thoughts

Regards

Suryanath

[Dr.Vishweshwara.R]

Dear Sir,
I appreciate your response.
The return on investment is a dynamic factor which poses one of the main questions in the implementation process , as its very difficult to measure the returns and in what terms to measure the ROI is also a problem.
ROI on HIS installation is subjective according ti dr.Wong you si of singhealth.
KPI are the key stages in the implementation process like AS-IS study, requirement analysis etc.

Sir, i would like to hear from your work ,

with regards,
dr.Ramachandran.

[Dr Suryanath Gudidevuni]

Dear Sir
I was once faced with the question of ROI from management. I think it is more to do with compiling and projecting. ROI is always there. following are some examples

Tangible ROI

Charge say Rs 100 per admission for maintaining their record lifelong
Charge say Rs 25 for duplicate documents like dischsrge summary, Lab report, prescription etc etc
Change Rs 150 for collating blood report over a period of time and report in graphical representation
Provide report on SMS for Rs 10
provide case history on internet for Rs 50

and the list goes on

Intangible are plenty and i am sure you don't need them

Regards

Surya

[Dr.Vishweshwara.R]

Dear sir,
Thank you .

regards,
vishweshwara