HIT or Miss, 3rd Edition: Lessons Learned from Health Information Technology Projects

Foreword. Introduction. Methodology. Section 1:CMIO Musing I: Six Blind Sages and the Elephant. Build It with Them, Make It Mandatory, and They Will Come: Implementing CPOE. One Size Does Not Fit All: Multi-hospital EHR Implementation. Hospital Objectives vs. Project Timeliness: Electronic Medication Administration (eMAR). Clinical Quality Improvement or Administrative Oversight: Clinical Decision Support Systems. Disruptive Workflow Disrupts the Rollout: Electronic Medication Reconciliation. Anatomy of a Preventable Mistake: Unrecognized Workflow Change in Medication Management. Failure to Plan, Failure to Rollout: Bar-Coded Medication Verification. CMIO Musing II: The EHR Spotlight. Basic Math: HL7 Interfaces from CPOE to Pharmacy to eMAR. Technological Latrogenesis from \"Downtime\": Pharmacy and Medication Systems. Trained as Planned: Nursing Documentation. Device Selection: No Other Phase is More Important: Mobile Nursing Devices. CMIO Musing III: It’s the Workflow, Stupid. Collaboration is Essential: Care Planning and Documentation. Lessons Beyond Barcoding: Lab Automation and Custom Development. Sticker Shock: Complexity and Cost for a Lab Information System. If It Ain’t Broke, Don’t Fix It: Replacing an HIS.A Single Point of Failure: Protecting the Data Center. Vendor and Customer: Single Sign-On. Ready for the Upgrade: Upgrading a Hospital EHR for Meaningful Use. Effective Leadership Includes the Right People: Informatics Expertise. Short-Sighted Vision: CPOE After Go-Live. Committing Leadership Resources: A CMIO and CPOE Governance. All Automation Isn’t Good: CPOE and Order Sets. Clinician Adoption: Community-Based EHR. Start Simple … Maybe: EHR Rollout in a Multispecialty Group Practice. CMIO Musing IV: The Inter-Personal Stuff. Leadership and Strategy – an Ambulatory EHR. Designing Customer Software for Quality Reports: A Community Health Center’s EHR. If It’s Designed and Built by One, It Will Not Serve the Needs of Many: Customer-Developed EHR. All Systems Down … What Now? Ambulatory EHR. Weekends Are Not Just for Relaxing: Reconciliation After EHR Downtime. CMIO Musing V: The HELP DESK. 104 Synergistic Problems: An Enterprise EHR. Push vs. Pull: Sharing Information Across a Physician Referral Network. Loss Aversion: Adolescent Confidentiality and PHR Access. Failure to Scale: A Teaching Module. CMIO Musing VI: Magical Thinking. Theoretical Perspective: A Review of HIT Failure. Call to Action.