One of my continuing interests is the use of information technology in hospitals. It’s a natural for me, because it lies at the intersection of two fields that I like -- medicine and IT. I’m particularly interested in technology that improves the way that medicine is practiced and delivered. One fascinating concept in this regard is the electronic medical record, or EMR. It’s also known as web-based patient data, electronic patient record, and the like. The motivating forces behind EMRs are their potential to reduce the cost of doing business, and their potential to improve the safety and effectiveness of the practice of medicine at both the individual and hospital level.

Getting EMRs operational is a difficult process. Techies don’t usually understand what doctors want from an EMR system, so it takes multiple iterations to get it right. That eats up time that most doctors don’t have. Further, doctors want different things from EMRs; they don’t like ‘one size fits all’ implementations. Finally, doctors despise anything that gets in the way of how they practice medicine; they can be the ultimate iconoclastic users. Since hospitals tend to cater to doctor’s needs, an EMR has to be exactly what the doctor ordered -- so to speak -- immediately.

An article in the current issue of CIO Magazine describes a medical center which has implemented such a system, and made it work. I was struck by how much the success factors sounded like the success factors for any project. First, the system had the complete support and financial backing of the local management team. It didn’t hurt that the management team was headed by a doctor, who spoke the users language and who understood what they wanted. Second, the system was sold first to the people who would get the most out of it right off the bat - the nurses, who often were stuck running errands for doctors, or doing documentation after the doctor left. Power users among the nurses adopted the system and promoted it with their colleagues; the nurses then sold it to the doctors, showing them by example how useful the system could be, selling it in the currency that matters most to a time-pressed doctor: efficiency.

Support, money, and functionality made the project work. It’s a valuable thing for techies to remember.
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