Measuring the Success of HIS/EMR Implementation

Measuring the success of HIS/EMR implementation is always a challenge because it is completely dependent on your ability to manage the change. It is very subjective in nature.  

People

UI: Find a common minimum between all stakeholders. Don’t get ambitious and try to satisfy everyone. Deliver only a basic version to start. Let them learn to drive on a Maruti 800 before you give them a Skoda. How will you objectively measure the organisation’s failure to arrive at a common understanding about the UI before the HIS/EMR implementation? This is at best a very subjective assessment.

After IT implementation people will become redundant in one part of the organisation e.g. General duty ward boys who carry files/papers and equipment; and organisation has to add more people with higher skill in another part of the organisation e.g. Bar code trained Pharmacists. Overall head count will go up in the short term until the organisation comes to terms the swelled up human resource with reskill, redeploy and/or retrench strategy. Therefore in the short term the cost actually goes up rather than comes down. How will you measure this success factor here? In the short term this is at best a very subjective assessment.

Resentment and resistance to change can lead to significant slowdown in the productivity. Sometimes it may lead to mass resignations and HR crisis. How will you measure the success factor here? In the short term this is at best a very subjective assessment.

Process

Prepare the organisation to accept big change in process. HIS/EMR implementation is an opportunity to make the workflow lean. Else the hidden errors and superfluous loops in the current process will get accentuated in the HIS/EMR. Don’t allow this - Usually CEOs soft peddle and say everything will remain the same the IT guys will take care of the difficult part in the backend! How will you objectively measure the organisation’s failure to remove unnecessary kinks and loops in the process before the HIS/EMR implementation? This is at best a very subjective assessment.

After IT implementation – the new procurements will become smoother. The parts of the Organisation that have surplus inventory will sit over it and other parts that have chronic shortage will keep ordering new procurement. Overall the inventory carrying cost will go up in the short term. Organisation has to learn to do resource optimisation before new procurement. How will you measure this success factor here? In the short term this is at best a very subjective assessment. 

Technology

Master Data: Human mind can live with ambiguity and work in chaos but a computer system needs clean master data. Organisation has to be forced to provide clean master data. How will you objectively measure the organisation’s failure to provide clean master data before the HIS/EMR implementation? This is at best a very subjective assessment.

After IT implementation – there will be an information overload to make decisions. Earlier the decisions were being done by gut feel. Now the Executives have to make decisions on lot of data. The decision making will slow down in the short term as they have to go through a learning curve.  Cost of sitting over problems and decision paralysis can be huge. How will you measure this success factor here? This is at best a very subjective assessment.

Given these challenges, many management consultants tend to measure success in terms of criteria such as:

-          Number of electronic Orders given

-          Number of electronic bills cleared

-          Number of Diagnosis without ICD codes

-          Number of procedures without CCI codes

-          Number of Lab tests without LOINC codes

-          Amount of Paper printed

However this is a very flawed way of measuring success because this can be measured only if you ever get to this point. The real challenges are much before reaching this point. And these indicators don’t point to the real cause in any case!

When you are going on the correct side of the road, it is hard to measure the cost of an accident that never happened.