Implementing an EHR customization can be a huge undertaking for a hospital or health system.
Here, five CIOs from hospitals and health systems across the country provide advice for organizations preparing to customize or enhance their EHR systems.
Editor's note: Responses have been lightly edited for clarity and length.
Question: What advice do you have for other hospitals looking to implement an EHR customization?
Danny Scott, CIO at Good Samaritan (Vincennes, Ind.): Have very strict governance in place and be extremely selective in what you permit. Don't have an open gate for people to submit changes they want. The less customization leads to a much easier maintenance and support process. I agree there are needs for optimizations, but don't be eager to move too far off the foundation. That's where the structure will get a little shaky.
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Joel Klein, MD, interim senior vice president and CIO at University of Maryland Medical System (Baltimore): It's important to get the most out of the organization's investment. It's also critical to make users feel empowered and not completely controlled by the software. Users typically know what takes the most time. Giving them the ability to save shortcuts to decrease repetitive tasks goes a long way toward reducing burnout and improving employee satisfaction.
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Avery Cloud, CIO at Franciscan Missionaries of Our Lady Health System (Baton Rouge, La.): I prefer the term personalization to customization, as customization suggests substantial changes to the base application; whereas personalization suggests innovating around the edges of the application, using application programming interfaces and other integration methods to introduce functionality not provided in the base application. However, when doing so, an organization would do well to become intimate with the EHR vendor's roadmap to avoid purchasing outside solutions that the EHR vendor is planning to release in future versions of their software.
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Tom Pacek, vice president of information systems and CIO at Inspira Health (Mullica, N.J.): Listen to users about what makes their day both easier and harder when using the EHR. It's important to use analytic data to help validate how broad an issue is. Then you can determine if customization is necessary. Whenever possible, it's best to target customizations that affect close to 50 percent of users and medical staff. Apart from small single-specialty areas, such as oncology or endocrinology, hospitals should avoid customizations for a single user or small groups. In addition, you'll want to make sure your organization is always monitoring any changes for desired outcomes.
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Mike Minear, senior vice president and CIO at Lehigh Valley Health Network (Allentown, Pa.): Spend time and money attacking real and material problems. Ensure you have a solid definition of the problem you are trying to address and ensure the scope of the problem is thoughtful and optimal versus trying to boil the ocean.
First, create a learning case where a high priority problem or challenge is identified, define a team with key people with different and relevant skills, and support the team until the problem is resolved. Assess this effort and refine how your organization will set up and operationalize change teams. Take the time to support and train other change teams in what you now know works for your organization. In other words, take the time to learn how to affect real change versus assuming people know how to do this and be successful.
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