Silicon gurney: EHR go-lives turn hospitals into software shops

Hospitals spend so much money on EHRs that it makes them veritable tech vendors, whether they like it or not, and that creates the opportunity to deliver a better user experience for clinicians, staff and patients.

Hospitals invest so much money in EHR implementations that it changes the very nature of their organization. And that means they need to think about operating more like a software company than just a hospital. If $100 million sounds like an exorbitant or even unrealistic ticket for an electronic health records platform, in fact, consider that Kaiser Permanente, Mayo Clinic and Partners HealthCare have publicly acknowledged spending an order of magnitude more than that — while other hospitals such as Scripps Health, Lehigh Valley Health Network, Lahey Hospital Medical Center and Lifespan revealed budgets bigger than $100 million. And that’s just to rattle off a fistful.

Thinking like a software vendor — if not technically becoming one of sorts as some hospitals are, in fact, doing today — starts with considering clinicians, administrators, executives and, really, all employees to be actual customers and then serving them as such. When Microsoft is working on a new operating system, for instance, it gives early versions to customers willing to test the software and offer feedback that Microsoft then incorporates into subsequent incarnations and it keeps that circle spinning through the product’s development lifecycle.

The secret sauce: iterative development. That’s software-speak but it also happens in medicine with new devices, new drugs, new standards of care, according to Adrian Zai, MD, the clinical director of population informatics at Massachusetts General Hospital’s Laboratory of Computer Science... Indeed, Leora Horwitz, MD brings a medical perspective to innovation at NYU Langone Medical Center, where she directs its Center for Healthcare Innovation and Delivery Science. Horwitz recommended that technologists pick the user-centered interventions that can have the biggest impact and incorporate front-line input, then offer evidence to clinicians and other users to prove that the software is working...