50% are Happy and 50% Fail

For my holiday reading, I chose " Practical EHR - Electronic Record Solutions for Compliance and Quality Care" by Stephen R Levinson, MD. I met Steve for the first time a few weeks ago at the eHealth Initiative 2008 annual meeting in Washington, DC. He had an amazing understanding of the relationships between Advanced (electronic) Clinical Documentation, coding, compliance, and the broader context of quality care delivery and reimbursement. That led me to order this holiday reading which just arrived. Steve was asked by the AMA to write an earlier book, Practical E/M. His Practical EHR builds on that powerful base. He's been teaching physicians, administrators, software engineers and others for over a decade. I thought this group would appreciate this specific perspective:

EHR Implementation and Marriage

The implementation of EHR systems in the United States has a track record like marriage: it has about a 50% failure rate, but that does not mean that all of the other 50% are happy.

To reduce physician-software incompatibilities, it will be important to include

• a more constructive "courtship" phase, with physicians and coders defining their EHR design requirements [emphasis mine];
  
• an "engagement" period, in which physicians conduct actual patient care trials to determine whether software systems meet their established benchmarks; and
• a possible "prenuptial agreement" to protect medical practice assets in the event of a failed "relationship."

Any individual or organization that is planning their physician documentation initiatives should take a look at this book. It's chock full of guides, templates, exemplary cases, checklists, relevant quotes and helpful perspectives from many of the industry's thought leaders. Steve also asked some interesting questions at eHI, but I'll save that for another time. Kate Gamble, as your most recent inductee to take the gamble, do you care to comment?