HIT or Miss, 3rd Edition

The third edition of HIT or Miss: Lessons Learned from Health Information Technology Projects presents and dissects a wide variety of HIT failures so that the reader can understand in each case what went wrong and why and how to avoid such problems, without focusing on the involvement of specific people, organizations, or vendors. The lessons may be applied to future and existing projects, or used to understand why a previous project failed. The reader also learns how common causes of failure affect different kinds of HIT projects and with different results. Cases are organized by the type of focus (hospital care, ambulatory care, and community). Each case provides analysis by an author who was involved in the project plus the insight of an HIT expert. This book presents a model to discuss HIT failures in a safe and protected manner, providing an opportunity to focus on the lessons offered by a failed initiative as opposed to worrying about potential retribution for exposing a project as having failed. Access expert insight into key obstacles that must be overcome to leverage IT and transform healthcare. Each de-identified case study includes an analysis by a group of industry experts along with a counter analysis. Cases include a list of key words and are categorized by project (e.g. CPOE, business intelligence). Each case study concludes with a lesson learned section.

Executive Editor - Jonathan Leviss MD, FACP Dr. Leviss has over 20 years of experience championing change and improvement across the health care industry at academic and community-based health systems, start-up businesses, not-for-profit organizations, and Fortune 100 companies and consulting firms. Recently he was appointed Medical Director for Clinical Innovation at Harbor Health Services, Inc., where he leads informatics-based programs for population health, value-based care, and overall organizational improvement across four community health centers, two PACE programs, and a Medicaid ACO. Prior roles include serving as the CMO at start-up companies, a state-wide HIE, and the first CMIO at NYC Health + HITECH. Dr. Leviss is a practicing primary care internist at Harbor Health Services, Inc. He has held faculty appointments at NYU, Columbia University, and currently has a faculty appointment at the Brown University School of Public Health. He is board certified in internal medicine (ABIM) and the subspecialty of clinical informatics (ABPM).

Foreword. Introduction. Methodology. Section 1:CMIO Musing I: Six Blind Sages and the Elephant. Build It with Them, Make It Mandatory, and They Will Come: Implementing CPOE. One Size Does Not Fit All: Multi-hospital EHR Implementation. Hospital Objectives vs. Project Timeliness: Electronic Medication Administration (eMAR). Clinical Quality Improvement or Administrative Oversight: Clinical Decision Support Systems. Disruptive Workflow Disrupts the Rollout: Electronic Medication Reconciliation. Anatomy of a Preventable Mistake: Unrecognized Workflow Change in Medication Management. Failure to Plan, Failure to Rollout: Bar-Coded Medication Verification. CMIO Musing II: The EHR Spotlight. Basic Math: HL7 Interfaces from CPOE to Pharmacy to eMAR. Technological Latrogenesis from "Downtime": Pharmacy and Medication Systems. Trained as Planned: Nursing Documentation. Device Selection: No Other Phase is More Important: Mobile Nursing Devices. CMIO Musing III: It's the Workflow, Stupid. Collaboration is Essential: Care Planning and Documentation. Lessons Beyond Barcoding: Lab Automation and Custom Development. Sticker Shock: Complexity and Cost for a Lab Information System. If It Ain't Broke, Don't Fix It: Replacing an HIS.A Single Point of Failure: Protecting the Data Center. Vendor and Customer: Single Sign-On. Ready for the Upgrade: Upgrading a Hospital EHR for Meaningful Use. Effective Leadership Includes the Right People: Informatics Expertise. Short-Sighted Vision: CPOE After Go-Live. Committing Leadership Resources: A CMIO and CPOE Governance. All Automation Isn't Good: CPOE and Order Sets. Clinician Adoption: Community-Based EHR. Start Simple ... Maybe: EHR Rollout in a Multispecialty Group Practice. CMIO Musing IV: The Inter-Personal Stuff. Leadership and Strategy - an Ambulatory EHR. Designing Customer Software for Quality Reports: A Community Health Center's EHR. If It's Designed and Built by One, It Will Not Serve the Needs of Many: Customer-Developed EHR. All Systems Down ... What Now? Ambulatory EHR. Weekends Are Not Just for Relaxing: Reconciliation After EHR Downtime. CMIO Musing V: The HELP DESK. 104 Synergistic Problems: An Enterprise EHR. Push vs. Pull: Sharing Information Across a Physician Referral Network. Loss Aversion: Adolescent Confidentiality and PHR Access. Failure to Scale: A Teaching Module. CMIO Musing VI: Magical Thinking. Theoretical Perspective: A Review of HIT Failure. Call to Action.