In part one of this series (link: http://bit.ly/hCb0MP ), I introduced the widely accepted premise that delivering complete, accurate, up-to-date, and relevant information to care providers, surpassing today’s norms by using information technology, would lead to better care. In part two (link: http://bit.ly/hgjELo ), I revealed that dozens of types of cognitive errors, when carefully studied, represented a much larger barrier to care improvement than deficiencies in HIT. I also suggested that simply mandating CPOE, drug checks, ePrescribing, problem/medication/allergy lists, calculated and transmitted quality measures, patient engagement enhancers, care coordination improvements (clinical information exchange), and privacy and security protections (collectively Meaningful Use Objectives and Measures of Stage 1) would be unlikely impact these known cognitive errors. In some cases, such as the commission bias, streamlining information delivery, documentation and taking actions (CPOE and ePrescribing) could conceivably increase the error rate.
This calls for even more attention to implementation and post-implementation monitoring, a capability that has been under-developed at least in the financial planning of HCIT roll-outs. The tell-tales are the length and staffing of the dedicated, post-go live functionality roll-out completion, clean-up, evolution, stabilization, and implementation usability “real world” optimization.
CMO & VP, QuadraMed
“Ignorance more frequently begets confidence than does knowledge.”
—Charles Darwin, 1871