Avoiding the "Trough of Disillusionment" With Healthcare IT

At the Becker's 20th Annual Ambulatory Surgery Centers Conference, held Oct. 24-26 in Chicago, Marion K. Jenkins, executive vice president of 3t Systems, discussed electronic medical record-related efficiency problems administrators should look out for when considering technology for practices.

"We are not yet at the point in healthcare where the information technology process fits the way clinicians like to work," he said.

His main sticking point for healthcare IT is that its systems are far behind those of other industries. While healthcare is on first or second generation technology, most industries are in their fourth or fifth technological generations, according to Mr. Jenkins. This is problematic, among other reasons, because HIT errors may be non-trivial, leading to serious injury or even death.

Clinician workflow disruption is one way errors can occur. Workflow may be arrested when systems are slow or require many passwords, which clinicians may or may not remember. Adding insult to injury, some processes still have paper duplicates, adding to the wait time and costs associated with electronic systems.

The clunkiness of these systems can lead to user-fueled HIPAA breaches. According to Mr. Jenkins, There have been 650 HIPAA breaches involving electronic medical records, affecting about 22 million records, since 2009. These breaches may occur because working in some HIT systems is time-consuming, encouraging clinicians to download records onto platforms susceptible to theft or hacking, such as laptops.

Another possible downfall when clinicians experience trouble operating EMRs is abandonment. "Most IT projects fail because of user resistance," said Mr. Jenkins. "In the ambulatory space, adoption is less than half."

He referenced the technology hype curve, a model devised by IT company Gartner: The curve shows a technology launching, a peak of expectations, a trough of disillusionment, a slope of enlightenment and a plateau of productivity. "The challenge for healthcare is the length of the trough of disillusionment," said Mr. Jenkins. "For a user with a new cellphone, that trough might be a few hours or a few days. For electronic medical records, the trough is between three and six months. Most technology abandonment happens then."

To avoid abandonment and lost productivity, Mr. Jenkins recommended cutting to the enlightenment portion of the technology hype curve by heavily investing in comprehensive training when adding any technology, electronic medical records included, to a healthcare facility.

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