Lack of clinical buy-in doomed GA hospital’s EHR rollout

By Kyle Murphy, PhD

– Details about the EHR implementation that forced two senior staff to resign from Athens Regional Medical Center (ARMC) have emerged with a lack of coordination and communication named as the chief cause according to Athens Banner-Herald.

Over the weekend, Kelsey Cochran reported that clinician input was undervalued and input from the hospital’s information technology department overvalued. Although not cited as the cause of their resignations, the hospital’s CEO and President James D. Thaw and CIO Gretchen Tegethoff tendered their resignations.

“The implementation was through the CIO, and so that’s where the information was held,” ARMC Senior Vice President and current CIO James L. Moore admitted last week. “Could there have been more information shared at the administrative level? I suppose you could make that argument.”

In 2013, ARMC contracted with Cerner to implement its Millennium at a cost of $31 million over 7 years, an agreement that would include support in the form of training and guidance to help the healthcare organization and associated facilities participate in the EHR Incentive Programs. According to Cerner Vice President Michael Robin, the trouble with the EHR implementation resulted from the hospital’s IT department assuming leadership of the project.

Once problems were identified, Cerner and third-party support came into help the hospital’s staff with the EHR system. Whether the clinical staff received proper training could not be verified.

The hospital responds

In an opinion piece published in the Athens Banner-Herald, ARMC Board of Trustees Chairman Rob Hoyt Athens Regional Healthcare System Board of Trustees Chairwoman Marilyn Farmer provided more insight into the events that precipitated the fallout at the Georgia hospital:

Relying on input from both senior administration and medical leadership, the board of trustees made a decision more than two years ago to implement an electronic record system and to contract with Cerner to guide this process. We made those decisions as part of a strategic process to advance patient safety, medical care and medical education at Athens Regional, as well as to meet new federal guidelines for the meaningful use of electronic records as part of the Affordable Care Act.

While we anticipated there would be challenges, particularly given the complexity and magnitude of adopting an integrated medical record system on a compressed timeline, the implementation of the Electronic Health Record system has not gone as well as we hoped.

The chairs made clear their support for the clinical staff, whom they credit with bringing the problems with the EHR implementation to the fore:

It is a tribute to our medical staff’s commitment to patient care that they pointed out the challenges they were facing with the new medical records system in a May 15 letter. We have been working diligently with them, with Cerner, with our nurses and our support staff to address those critical issues. We have made considerable progress since then, and will continue to prioritize and address critical issues.

It is important to remember that health care is a people-driven profession. We manage a lot of data, systems and information, and we use a lot of equipment and computing capacity to do so, but the most important element is our people. The systems are important, but only to the extent that they enable our health-care professionals to provide unrivaled care to our patients. Ensuring that our patients receive the best care in a stable, safe and compassionate environment remains our focus.

Moreover, they admit that the episode has served as a learning experience for the higher-ups as well:

As a board, we have learned some important lessons through this process as well. We understand more fully the importance of communication with both internal and external audiences. We are also more visible in the life of the hospital and staff, within the appropriate guidelines for board responsibilities.

Moore is taking over as the administrative lead for the health system while the board and the Medical Executive Committee and health system’s leadership create and interim strategic and search for a new CEO.

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