HIT: not all about IT

Much money is spent on clinical applications and too often we say hospitals have developed isolated silos of information. EHR will hopefully remedy this situation, but frequently the selection and implementation of a new specialty application is conducted with a focus that is too narrow. This results in different groups being dissatisfied and also delivers less than stellar returns on the investment. Clinical applications might have a computer program at their heart but they are hugely multi-dimensional and a successful project needs more focus on the elements often regarded as peripheral.

For example, the implementation of an emergency department information system (EDIS) needs to integrate with the rest of the hospital systems (hospital information system, pharmacy, radiology, lab, respiratory therapy, environmental services, communications, clinical data repository, billing, etc.). This requires planning for, and evaluation of such things as compliance issues, legal aspects, metrics for performance, incorporation of quality initiatives, workflows and workflow redesign, user interfaces, user buy-in, unexpected obstacles, common dictionaries, order sets, formularies, handling referring and primary care physicians, granularity of access, and exchanging data with other facilities. The preceding list illustrates some of the complexity involved when integrating with enterprise applications and the need to lay a solid foundation to ensure outcomes when moving to a new clinical tool.

The old saying of measure twice, cut once applies in this situation. Being prepared with knowledge and commitment will make the IT portion of the implementation that much easier.