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EHR's and Organizational
Change
Panelists: Melissa Larkin-Skinner, Chief Clinical Officer, Manatee Glens, FL
Steve LaFleur, Chief Information Officer, Grand Lake Mental Health Center, Inc., OK
Ravi Ganesan, President, Core Solutions, Inc., PA (Moderator)
Title
Organization
Agenda
• Brief Introductions
• Transformational Impact of EHRs
• Case Studies
– Grand Lake Mental Health Center, Inc., OK
– Manatee Glens, FL
• Q&A
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EHRs Can be Transformational
Clinical
• Improved Quality
– Quality of Life
– Housing
– Jobs
– Medication Management
– Reduced Hospitalizations
Financial
• Increased Revenue
– Ability to service more
consumers
• Reduced Costs
– Reduction in resources
required to complete
certain job functions.
Opportunity For Transformational EHRs
Source: Physicians’ Views on Clinical Information Technology, Raymond A. Gensinger, Jr., MD, CPHIMS, FHIMSS.
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Transformational Impact of EHRs
Transformation
Organizational Culture
Resistance to change
Change Management
Creating a Culture of Adoption
• Lessons From Bill Rieger, CIO of Flagler
Hospital
– Project vision “beyond using our EMR to leveraging
our EMR.”
– Guiding Principle “Such a system would improve
quality, reduce the cost of healthcare, foster loyalty,
and enhance our service to the community.”
– Patient Centered Care Team
Source: http://www.healthcareguy.com/2013/09/09/creating-a-culture-of-adoption-for-ehrs-and-health-it/
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Creating a Culture of Adoption
• Lessons From Bill Rieger, CIO of Flagler
Hospital
– “There’s power in ceremony. People don’t
forget. They talk about them and relive them.”
– Adoption results and goals centered on Quality,
Efficiency, and Cost.
– “Culture is not just for Google or Apple. You are
creating a culture whether you like it or not. You can
lead your culture towards adoption or not. There will
be a culture either way.”
Resistance To Change
• Impacts
– Project delays
– Budget overruns
– Underutilization
• Theoretical Research
– Equity Implementation Model
– Status Quo Bias
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Equity Implementation Model
Net Equity
+/- Outcomes
+/- Inputs
Level 1
Level 2
Level 3
Perceived outcome for the user compared with
perceived outcome for the employer
Perceived outcome for the user compared with
perceived outcomes for other users
Source: Use of the Equity Implementation Model to Review Clinical System Implementation Efforts. Thomas W. Lauer, PhD,1 Kailash Joshi, PhD, and Thomas Browdy, PhD
Equity Implementation Model
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Change Management
Source: Change Management in EHR Implementation, National Learning Consortium http://www.healthit.gov/sites/default/files/nlc_changemanagementprimer.pdf
Change Management
Source: Change Management in EHR Implementation, National Learning Consortium http://www.healthit.gov/sites/default/files/nlc_changemanagementprimer.pdf
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Change Management
Source: Change Management in EHR Implementation, National Learning Consortium http://www.healthit.gov/sites/default/files/nlc_changemanagementprimer.pdf
Change Management
Source: Change Management in EHR Implementation, National Learning Consortium http://www.healthit.gov/sites/default/files/nlc_changemanagementprimer.pdf
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Case Study
A CLINICAL LEADERSHIP PERSPECTIVE
Melissa Larkin-Skinner, MA, LMHC
Chief Clinical Officer Manatee Glens
Leadership Commitment
Vision
Communication
Resources
Support
Empowerment
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Organizational Project vs IT Project
Executive
Clinical
Finance
IT
Data
Records
QI
Compliance
Goals
Intent
Direction
Revisit often
Avoid mission creep
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Why?
Really Why
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Interpreters Needed Clinical
Finance
IT
Finance
IT
User Readiness
Introduction
Skills
Training
Expectations
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Manage Expectations!
How?
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The Forever Project
Case Study
A CHIEF INFORMATION OFFICER’S
PERSPECTIVE
Steve LaFleur
Chief Information Officer
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Grand Lake Mental Health Center
• Outpatient Behavioral/Physical Health
Services
• Serving NE Oklahoma (over 5,000 square
miles) since 1979
• 3,160 Active Clients – 2266 Adults and 894
Children
• 10 Physical Locations - 255 Staff
Grand Lake – EHR Evolution
• Early adopters of EHR
– Initial focus on billing and A/R (1995)
• Moving EHR in a strategic direction
– Upgraded Billing Software (2000)
– Decision to Bring on CIO in 2010
– Accelerated Clinical Implementation (2010)
– Moved from doubting data to leveraging data
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Strategic Goals
• Time To Market
– Changes at the state level required GLMHC
to be able to respond rapidly to survive and
thrive. GLMHC choose to thrive!
• Focus on Performance
– Intense focus on performance (billable hours,
outcomes) at all levels of the organization.
• Decentralization
– Move to a decentralized organization by
empowering supervisors and staff with data.
Organizational Change
Culture
• Performance Oriented • Commitment to continuous improvements
and incremental changes
Resistance To Change
• Well defined performance metrics • Willingness to enforce standards • Benefits of negative thinking
Change Management
• Simple, logical, incremental changes • Willingness to make mistakes and correct
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Q&A
THANK YOU
