In reality Use precedes Meaningful Use
Implementing CCHIT-certified EMR is only the first step; for achieving Meaningful Use (MU). It's very logical that EMR has to be used first before we can expect meaningful use. Starting to use EMR that an organization has implemented sounds deceptively simple and a non-issue but the truth is EMR adoption in US has been significantly low. Umpteen reasons have been attributed to lower adoption of EMR including dollar investments required, unclear ROI, lack of interoperability infrastructure for healthcare data sharing, reduction in face-time with patients at point of care, longer visit times that directly impacts revenues and ineffective training of staff and physicians.
US government's commitment of USD 19.2 billion under ARRA HITECH Act has spurred providers into seriously considering EMR adoption. History has many examples of healthcare IT implementation failures due to lack of user adoption. Enabling healthcare staff to meaningfully use EMR requires focused approach to sustained end user adoption and learning. There is no one-size-fits-all solution for EMR adoption and different organizations may need different set of strategies to ensure MU. So, how do providers ensure EMR adoption for Meaningful Use?
First step would be to generate awareness amongst EMR users regarding the ARRA HITECH Act's vision of leveraging healthcare IT to reduce healthcare costs and improve quality of care. They need to be sensitized about the important role each one of them has to play in turning this vision to reality. Secondly, EMR users need to be engaged during EMR implementation and their constructive feedback should be incorporated in EMR configuration. While the EMR system cannot be configured for each user's preferences as it compromises efficiencies that results from process standardization, a balanced level of personalization can be offered. Third and most important aspect is training for sustained end user adoption. Many large services organization recognize the significance of training in IT adoption and now have dedicated knowledge services units that bring in know-how of latest knowledge management technologies and behavioral science to ensure IT adoption. Training should be made accessible to EMR users anytime, anywhere so that it does not interfere with their job and they have flexibility to go through training based on their schedules at a pace comfortable to them. Multiple approaches of training delivery (like classroom training, Computer Based Trainings, one-click online help, helpdesk call center, online chat with helpdesk staff, user community forums, FAQs etc.) can be used to allow increased flexibility to EMR users. A successful best practice for healthcare IT adoption has been to identify physician and nurse champions who will be early adopters. Early adopters will be able to point out practical challenges that are faced by EMR users at point of care. The training plan developed in collaboration with physician and nurse champions must provide guidance on overcoming these practical challenges. Last but not the least, provider organization's policies must promote and encourage sustained use of healthcare IT.
