May 31, 2017

EHRI'm at a user-group conference for the EHR that my hospital recently implemented. I came to speak about the implementation from the physician perspective. The implementation has had its ups and downs, but we were able to return to our pre-implementation volume about three months after go-live. This is similar to what I have heard from others who have changed systems. The most unfortunate part of our change was that a large part of the work landed on the staff at the front lines - the medical assistants and primary care providers who needed to make sure the data from the old system was manually entered into the new system. This continues to be a heavy burden.

I listened to a presentation on LEAN principles yesterday. I enjoyed hearing the structure and tools that can be employed. There seem to be many parallels to the Quadruple Aim and LEAN. Where this brings me is how LEAN seeks to remove waste from systems and how so much needs to change in healthcare to remove the waste.

At just this one user-group meeting, there is an enormous number of sponsors and sub-vendors who have large budgets to try to sell us additional components to make the EHR more functional. Seeing this level of marketing seems so far away from the individual physician-patient encounter and very expensive for the investment. I wonder if there is a vendor who could successfully take the manual data entry task away and lighten the burden? I hope so for future implementations, unfortunately for ours it is too late.


Deb Harrigan, MD

Please send comments or questions to