HIT or Miss, 3rd Edition

This third edition 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. Thought provoking commentary chapters add additional context to the challenges faced during HIT projects, from social and organizational to legal and contractual.

Executive Editor - Jonathan Leviss MD, FACPDr. 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).

About the Editors and Contributors. Acknowledgments. Forward. Introduction and Methodology. PART I: Hospital Care Focus. Chapter 1 Build It with Them, Make It Mandatory, and They Will Come. Chapter 2 One Size Does Not Fit All. Chapter 3 Putting the cart before the horse--IDN Integration. Chapter 4 Hospital Objectives vs. Project Timelines. Chapter 5 Clinical Quality Improvement or Administrative Oversight. Chapter 6 Business Intelligence--legacy shortfall reinforces a new endeavor. Chapter 7 Legacy Data Viewer--when value endures. Chapter 8 Medication Alerts--usability reigns supreme. Chapter 9 Antibiotic approvals--A mobile app that didn't. Chapter 10 Disruptive Workflow Disrupts the Rollout: Electronic Medication Reconciliation. Chapter 11 Anatomy of a Preventable Mistake: Unrecognized Workflow Change in Medication Management. Chapter 12. Failure to Plan, Failure to Rollout. Chapter 13 Enterprise EHR for Obstetrics--Fitting a square peg into a round hole. Chapter 14 Basic Math. Chapter 15 Mobile Devices--when in with the new does not mean out with the old. Chapter 16 Pharmacy System Upgrade--first time failures ensured later success. Chapter 17. Device Selection-No Other Phase Is More Important. Chapter 18 ICU Data Capture-how many systems is too many. Chapter 19 Fetal Monitoring--simultaneous systems migration. Chapter 20 Critical Lab--notification failure. Chapter 21 Collaboration Is Essential: Care Planning and Documentation. Chapter 22 Lessons beyond Bar Coding. Chapter 23 A Single Point of Failure. Chapter 24 Vendor and Customer. Chapter 25 Communications Upgrade--the phone's on, but nobody's home. Chapter 26 Ready for the Upgrade. Chapter 27 Effective Leadership Includes the Right People. Chapter 28 Chronic Care Model--Organizational Culture eats Implementation Strategy for Lunch. Chapter 29 Shortsighted Vision. Chapter 30. Committing Leadership Resources. Chapter 31 When to throw the towel--ED Downtime. Chapter 32 Voice Recognition--when life throws you lemons, make lemonade. Part II: Ambulatory Care Focus. Chapter 33 All Automation Isn't Good. Chapter 34 Start Simple. Chapter 35 It's in the EHR...but where?? CHapter 36 All Systems Down...What Now? Ambulatory EHR. Chapter 37 Weekends Are Not Just for Relaxing. Chapter 38 104 Synergistic Problems. Chapter 39 What defines "failure"?--A Small Practice EHR. Chapter 40 Digital does't always mean easier. Part III: Community Focus. Chapter 41 Push vs. Pull. Chapter 42 HIE Alerts--disconnecting primary care providers. Chapter 43 Loss Aversion. Chapter 44 Care Coordination--Improved population management requires management. Part IV: Points of View. Chapter 45 Theoretical Perspective. Chapter 46 EHR Transitions--deja vous. Chapter 47 User Interface--poor designs hinder adoption. Chapter 48 Exploring HIT Contract Cadavers To Avoid HIT Managerial Malpractice. PART V: Appendices. Appendix A - HIT Project Categories. Appendix B - Lessons Learned Categories. Appendix C - Text References and Bibliography of Additional Resources. Index