Another Failed EHR Implementation – Surprised? Not

Albert Einstein is credited with defining insanity as “doing the same thing but expecting a different result.”  And so it goes with another EHR implementation gone bad…

The Royal Berkshire Foundation Trust in Reading, UK recently announced they had to write off £18 million ($28 million) due to the recent implementation of an EHR system (Article here).  According to CEO Ed Donald, “Unfortunately, implementing the [EHR] system has at times been a difficult process and we acknowledge that we did not fully appreciate the challenges and resources required in a number of areas.” Huh?  Since the British are far more eloquent in their explanations, allow me to provide a translation: “We thought we could pay a vendor, flip a switch, and it would work.”  Unfortunately, that translation is not limited to my British friends, but works for every hospital CEO trying to explain a EHR implementation gone horribly wrong.

I would imagine this project failed in two key areas:

  1. It was probably treated as an IT project, instead of a business project involving IT (read more here)
  2. The People, Process, Technology approach was likely Ignore the People, Glance at the Process, Focus on the Technology instead of Focus on the Process, Engage the People, Prepare for the Technology (read more here).

The hard part is, this is hard.  Really hard.  Business/Operations owners must be fully engaged from the start for the duration, and resources have to be dedicated and aligned throughout (even before the official project “kickoff”).

I don’t know the details or full history of this situation, but I imagine it parallels many I have come across.  It is highly unlikely that no one mentioned to the senior leadership of the hospital how difficult this would be, and how important it would be to put the proper amount of resources on the project, after all, we’re talking close to $50 million.   It is also highly likely the senior leadership responded with “we can’t afford that, what is the minimum we can do?”  After all, the up front sticker shock to do these types of projects properly can require a trip to the ER to check your heart.  So they played it “safe.”

The CEO says he will not resign, despite pressures from the local media, but one wonders if he should be sacked?  There’s clearly not enough information publicly available to make that call, but “not fully appreciating the challenges and resources required” should have consequences.  Unfortunately, those consequences will likely fall on some poor Project Manager and the vendor, and not on the executives who ultimately made the call not to invest resources up front.  The same executives that will move on to other healthcare organizations and make the same decisions about resources on the next project and have the same poor outcomes.

Insanity? Perhaps.  But until organizations decide to truly do things different, to make the hard choices up front, when they are the hardest, to have true courage and resolution, things will continue as they always have… and that’s just crazy.

Until next time!

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One thought on “Another Failed EHR Implementation – Surprised? Not

  1. Glenn,

    interesting problems that come up again and again. To me, if you want a project to succeed, start small. Big software projects are much more difficult. Too many people, too much complexity, too many different organizations with different outlooks and goals.

    The perfect size for a new project? One person, who works for the company, has high credibility and who can work on one thing. The project shouldn’t take more than 4 months to complete. It’ll probably take 6 months. But at the end of that time, that one person will have a good idea of what it takes to make an implementation succeed. They should lead the project, scope it and have a large promotion/pay raise/bonus awaiting them when the project succeeds in a predefined period of time.

    That person has the best chance to scope, staff, track and manage the project successfully. Whether it’s EHR, ERP, BPO, CRM or any other IT based project.

    Failing that, be sure you’re being paid by the hour,

    Andy

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