Maximizing Your Quality Investment-Health 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!

Basic EHR adoption increased 5x from

2009 to 2014¹

+47%

12%

59%

2009 2014

1Charles 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.

+23%

26%

2009 2013

Comprehensive EHR implementations increased

8x from 2009 to 2013¹

3%

The Adoption Gap

Adoption defined as 75% of physicians using the functionality according to prescribed best practices.

ClinicalDocumentation

Testing andImaging Results

Clinical DecisionSupport

ComputerizedProvider Order Entry

Installed

Physician Adoption

91%

55%

91%

96%

84%

41%

73%

44%

Survey of CHIME CIOs:

Long-Term Commitment:Adoption is a Process, Not an Event

Divorce Rates on the Rise

The number of buyers replacing existing EHR software hasincreased 59% since 2014.

Software Advice, EHR Software BuyerView 2015; http://www.softwareadvice.com/medical/buyerview/ehr-report-2015/

0% 10% 20% 30% 40% 50% 60% 70%

Q1 2015

Q1 2014

Q1 2013

Q1 2010

37%

48%

50%

63%

60%

40%

30%

20%

Replacing Commercial EHR Replacing Paper

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

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

50,000

1 3 5 7 9 11 13 15 17 19 21 23 25 27

Months

Users from January 2014 – March 2016

users

A Dramatic Paradigm Shift

95.0%88.0%

Ensure High Performance

Overall simulationcourse 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

End-user adoption

measured in terms that

connect directly to the

expected clinical and

financial outcomes.

Performance Metrics

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

Optimization

Fluency

ThresholdProficiency

Readiness Implementation Utilization Upgrades &Additions

Adoption

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, PhDhhaugen@thebreakawaygroup.com

303.483.4300

www.thebreakawaygroup.com