Maximizing Your Quality InvestmentHealth Information Technology Adoption
Heather Haugen, PhD | CEO and Professor
Agenda • The value of technology adoption to achieve outcomes • Understanding the healthcare IT landscape: replacements, new technologies, and adoption challenges
• Examining how other healthcare organizations are achieving value from technology • Recommendations for leading, educating, measuring and sustaining technology adoption
Healthcare IT Disruption!
59%
+23%
+47%
26%
12% 2009
3% 2014
Basic EHR adoption increased 5x from 2009 to 2014¹
1Charles
2009
2013
Comprehensive EHR implementations increased 8x from 2009 to 2013¹
D, Gabriel M, Furukawa MF. “Adoption of Electronic Health Record Systems among U.S. Non-federal Acute Care Hospitals: 2008-2013,” ONC Data Brief, no. 16. Washington, DC: Office of the National Coordinator for Health Information Technology. May 2014.
The Adoption Gap 91%
Clinical Documentation
55%
Physician Adoption 91%
Testing and Imaging Results Clinical Decision Support Computerized Provider Order Entry
Installed
96% 84% 41%
73% 44%
Survey of CHIME CIOs: Adoption defined as 75% of physicians using the functionality according to prescribed best practices.
Long-Term Commitment: Adoption is a Process, Not an Event
Divorce Rates on the Rise The number of buyers replacing existing EHR software has increased 59% since 2014. 20% Q1 2010
63% 30%
Q1 2013
50% 40%
Q1 2014
48% 60%
Q1 2015
37% 0%
10%
20%
30%
Replacing Commercial EHR
40%
50%
60%
70%
Replacing Paper
Software Advice, EHR Software BuyerView 2015; http://www.softwareadvice.com/medical/buyerview/ehr-report-2015/
Understanding the Barriers to Adoption
Implementation is not adoption! Myopic attention on go live.
Leading adoption is often misdirected toward IT or the CIO. Traditional training methods are ineffective and insufficient, mostly event-based.
Metrics, specifically adoption metrics, are non-existent. Sustainment of EHR adoption, for the life of the application, is usually left to chance.
Engaged Leadership The insight, will and ability of leaders to correctly govern and continuously inspire the team to achieve the intended outcomes.
Recommendations Clearly define ownership Allow/expect governance to evolve Require compliance Influence and lead
Speed to Proficiency Clear understanding and knowledge of the new application, by role, FAST. The ability to use the application to provide care.
Consistent Experience for All Users
Users from January 2014 – March 2016 50,000 45,000 40,000 35,000 30,000 25,000 20,000
users
15,000 10,000 5,000 0 1
3
5
7
9
11
13
15
Months
17
19
21
23
25
27
A Dramatic Paradigm Shift
Ensure High Performance
88.0%
95.0%
Overall simulation course completion for users
Practicum exam average score for learners (role-based)
Recommendations Develop role-specific learning Use scenarios Develop sandbox activities Value “fast failure”
Create “bite-sized” learning Reinforce with visual verification
Step on the Scale
Performance Metrics
End-user adoption measured in terms that connect directly to the expected clinical and financial outcomes.
Recommendations Measure proficiency first Define clinical outcomes of interest Share data early and often Don’t forget about financial outcomes
Use data to drive process improvements Capitalize on the competitive spirit of clinicians
Adoption Sustainment A long-term focus on the people, processes, and evaluations to improve adoption over the lifecycle of the application.
The Tyranny of Time- Adoption has a Lifecycle
Adoption
Optimization
Fluency
Threshold Proficiency
Readiness
Implementation
Utilization
Upgrades & Additions
Recommendations Identify the roles needed after go live Define governance for sustainment Design a process for updating learning materials Annual or quarterly assessments–random is fine
Use peer networks
What if we invest all this time and money in training our people and they leave?
What if we don’t and they stay?
Questions?
Heather Haugen, PhD hhaugen@thebreakawaygroup.com 303.483.4300
www.thebreakawaygroup.com