The Critically Sequential Path to Success

It is really important to understand that without the proper phasing when introducing health information technology (HIT), there are significant risks of doing more harm than good. The pervasive approach in the industry today is to think that bringing in the right technology will lead to benefits or “meaningful use.” The bulk of the real evidence, suggests otherwise. The evidence is that starting the transformation by either first trying to select the right technology, or by first focusing on PCMH/MU requirements gives the following options:
#1. Turn clinicians into data trolls. Patient care then is more about dibbling around with a computer, staring at a screen (rather than patients), and then fuming as the waiting rooms backs up with coughing, puking patients.
#2. Clinicians spend evenings with the new EMR mistress entering data.
#3. Clinicians limp along with significant productivity losses at the point of care, and just hope the crutches from the profit centers will hold out.
#4. To avoid the above, clinicians get a paper-behind-glass EMR solution and imagine that it goes anywhere needed. This is sort of like the kid in the pedal airplane. Not bad, as imagining is fun, but you will never actually get there.
#5. Clinicians just say no! Be either a little scroogy, or pretend to be ostrich with head buried. This approach will become increasingly unpleasant as the real world changes. It is really interesting the degree to which the focus in the industry remains primarily on the incentive (or lack of) in the Medicare/Medicaid Stimulus Bonuses for “Meaningful Use.” The effects of losing out on this initiative are going to pale compared to the effects from what other payers are going to do. Most private payers are now waking up and realizing that the gig is just about up on volume-based, fee-for-service health insurance products. Whether the future is Accountable Care Organizations or Patient-Centered Medical Homes (or likely a combination), the medical practices unable to manage their own information in means that serve them and their patients are going to see major losses of income, status, and quality of care. Not starting the transition is not so much about losing out on the $44k stimulus bonus, but is more about:

Accept a 30% income difference in 2-3 years due to lack of information technology capability. Or wait another year to get started, and only have perhaps a 10-20% income differential in 2-3 years.

Now is the time for paper-based medical practices, along with most using non-comprehensive EMR systems, to start the journey. Now is the Time, Here is the Path. The 10 steps in this link were written as a path to PCMH, but the steps are pretty much the same for any type of medical practice.
The 10 steps are critically sequential. Starting at step 6 with an EHR while skipping the Team Care and earlier steps will leave you with one of the choices above.

Pick a number?

Again, why would any clinician prefer to work harder, not be able to justify their quality of care, and experience significant losses of income when the opposite is possible today?