Comments on: ONC seeking comment on regional EHR center plan

By: John Lynn

John Lynn — Mon, 15 Jun 2009 16:34:17 +0000

I’m still disappointed that in the money for these training centers, there’s not also provisions that require a coordinated effort to put the findings online and leverage technology to educate people all over the country as opposed to just these centers.

By: Joseph Kim, MD, MPH

Joseph Kim, MD, MPH — Wed, 03 Jun 2009 02:44:57 +0000

Physicians and hospitals are having a difficult time understanding how an EHR should fit into their daily workflow. There are so many unanswered questions (including the endless discussions on “meaningful use”) that need to be addressed before most physicians can really understand the full implications of implementing an EHR. The vast majority of physicians are not familiar with some of the basic technical issues that surround EHR implementation and usage. Therefore, their heads are spinning. My hope is that more efforts will be made to educate, train, and equip physicians before they’re asked to understand all these proposals and make important decisions based on them.

By: Ed Stern, RN

Ed Stern, RN — Tue, 02 Jun 2009 12:42:12 +0000

In concept the program idea has merit, implementing an EHR isn’t the same as installing a shrink wrapped product on your PC. There’s a great deal of prep, planning, and adjustment (of the technology and the clinical processes) that need to be made etc.

Healthcare (and the management of healthcare process) isn’t like going to McDonald’s. McD’s takes pride is the fact that the Big Mac is made the same where ever you go. You simply can’t make the “Medical Big Mac” the same way in every location, and this is what adds layers of complexity to the implementation of an EHR.

Maybe it’s the nurse in me, or the person who’s been in on my fair share of implementations, but there should be a few primary goals of these “Centers of Implementation Excellence” (CIE: hey why not everything else in HIT has an acronym).

1.) They should include a strong focus on education and planning assistance (most Doc’s don’t have the resources or the time). 2.) They should work with the Vendors to help them “get it” — meaning the vendors need someone to help be the liaison into the medical care processes the CIE serves. 3.) They need to be able to make sure the medical providers in their communities have a way to support their efforts post go-live, and that these medical providers have the resources to provide input into the implementation planning, and don’t have to “adapt and adopt” a different workflow just “because”

If we focus on (and sorry to steal an over used quote) “teaching them to fish” these centers have a strong change of survival.

By: CCHIT Staff

CCHIT Staff — Tue, 02 Jun 2009 06:37:22 +0000

@Steve Daviss Thanks for mentioning the broken link. We’ve pointed to a different resource for the information.

By: Steve Daviss

Steve Daviss — Tue, 02 Jun 2009 05:43:40 +0000

(The link is dead to the ONC plan in the Federal Register.)

I am very much in favor of having some sort of review or rating mechanism for their implementation of EHR (whether certified or not). Users (docs, nurses, lab techs, etc) would be able to rate their systems based on meaningful usability. By tracking based on implementation (say, by hospital), one can better determine the degree to which poor usability is due to deficiencies inherent in a particular EHR vs those resulting from poor implementation.

This would also be an incentive for EHR companies to do a better job of providing post-implementation support, which in turn would improve our ability to be a “Meaningful User” (sung to tune of “Beautiful Dreamer”).