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A Few Tips for CIOs...

May 12, 2008
by James Feldbaum
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So much has been written about CPOE and tips for its implementation that most CIOs have committed “lessons learned” to memory. Most authors, including me, have been over-inclusive in their advice. So, skipping the usual, albeit critical, advice of engaging physicians early, etc. let me enumerate a few subtleties.

  • Keep the software selection scenarios simple. Don't allow your consultants to create unrealistic scenarios that encourage competing software providers to demonstrate functionality, real or phantom, that your physicians will not use in the early phases of adoption. It is easy to overwhelm an inexperienced selection team who are not yet able to discriminate critical from superfluous functionality.
  • Don't overpromise. It is not necessary or advisable to go live with a complete suite of software all at once. In a user's eye failure in one aspect of the EMR often overwhelms the sense of the success of others.

  • Don't over demonstrate. I am a physician so I can say it: we have a short attention span when it comes to watching software demonstrations. After 10 minutes or 10 slides you start to lose us. If your goal is to engage without frustrating or overwhelming keep it short.

  • If possible teach one-on-one in a realistic, if not live, hands-on session that does not exceed 45 minutes.

  • Make sure that the supporting IT component is bulletproof. CPOE detractors are looking for an excuse to derail your implementation. The IT department is a favorite target. Don't let the software get ahead of your ability to support it.

  • Don't cannibalize your clinical systems team once you are up and running. A dedicated and experienced clinical systems team is just as important in the later phases of an implementation as it was in the initial ones.

  • You do not have to participate in every upgrade in the software. A move from 4.3 to 4.4 may add enhancements that you really don't need.

  • Don't allow the administration to tie you to an unrealistic implementation schedule. Avoid artificially imposed deadlines. Nothing destroys your schedule more than failure. Move only at the speed of success.

There are other tips that could fill pages, but CIOs too have limited attention spans.

There cannot be a crisis next week. My schedule is already full.

Henry Kissinger (1923 - )

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James Feldbaum

Jim Feldbaum is a physician consultant specializing in clinical transformation, CPOE, and...