Viewpoint: 5 steps for successful EHR adoption

There are five key lessons Oakland, Calif.-based Kaiser Permanente officials learned after installing a comprehensive EHR across the health plan and medical group, Robert M. Pearl, MD, former CEO of the Permanente Medical Group, wrote in a Harvard Business Review op-ed.

Here are the five lessons Dr. Pearl learned from the EHR rollout, which took place roughly a decade ago.

1. Implement a comprehensive EHR. When Kaiser Permanente officials first considered an EHR, they attempted to design and build their own, customizing the system for each speciality. However, they soon realized they needed to implement a single, comprehensive EHR that contained all of a patient's medical information across all specialties and physicians.

2. Prioritize physician buy-in. Many physicians worried the EHR would emphasize coding and billing rather than clinical outcomes. However, with the comprehensive EHR, physicians were able to experience the benefits first-hand. "Rather than having to wait for a patient's records to arrive from their colleagues' offices, [physicians] could access the information immediately," Dr. Pearl wrote.

3. Establish organizational trust. Dr. Pearl emphasized how physicians will often be resistant to systemwide change, such a new EHR rollout, unless they trust their organization's leadership. As CEO of the Permanente Medical Group, Dr. Pearl decided to visit each one of the system's medical centers to meet with physicians and discuss the clinical impact of EHRs.

4. Recognize all employees — not just physicians. When Kaiser Permanente rolled out its EHR, other employees, such as medical assistants, voiced concerns about increased work from documentation. The system's officials subsequently launched a program called "I Saved a Life," to celebrate the work medical assistants did by reviewing patient records, for example, to identify gaps in preventative care.

5. Ensure access to technical support. An EHR rollout doesn't only require preparatory training, Dr. Pearl wrote, it also necessitates ongoing technical support. He noted how, in the first few weeks of the systemwide implementation, physicians who had already went live with the EHR acted as "consulting experts" to their peers.

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