Thoughts on EHR Difficulties and Failures – #2

The transformational character of introducing an electronic health record (EHR) into an enterprise must be well planned and based on foundational work. Because an integrated environment is so interdependent, the absence of policies coordinating the building of interrelated modules and applications can lead to wasted effort and create rework once the unworkability or excessive cost of supporting the configuration is recognized.


Another aspect of dissipating effort and resources are the adoption of deadlines without having contingency plans that allow for the flexible deployment of the EHR to occur after it has successfully passed testing and user acceptance. Often the deadlines are linked to some other events whose prime focus in not the EHR. Similarly, an organization’s executive management must ensure that the project scope is maintained and vigilantly stop or downgrade unassociated projects or unnecessary scope creep.


Establishing the methods for change management (in the integrated environment), coordination and scheduling of build and testing environments, and establishing a sercurity model for user and application access can lead to signigicant simplification of security maintenance while safeguarding protected health information (PHI). Planning for the vetted release of information to indivuals and other healthcare providers should be addressed as part of the architectural design of the EHR. The trend line is that health information exchange (HIE) is becoming one of the main tentants of ARRA HITECH Meaningful Use requirements.