Going Live With A EMR is as Easy as Jumping Out of an Airplane

Short Link: http://j.mp/6ke8Y5

Whenever I need help thinking outside the box I call on Dave Hubbard. For example, a few months ago I was trying to think of a good analogy to workflow in a medical office and Dave and I ended up co-writing about similarities between football plays and medical workflow. It’s been a popular post, web traffic wise.

Recently I considered the value of a positive customer experience of implementing a EMR and the beneficial transformations that can be achieved. I drafted a blog post, but it was, frankly, a dry exposition about economics of EMRs as commodities, goods, services, experiences, versus opportunities for transformation. (Entirely what you would expect though, from a premed Accountancy major.)


Dave Hubbard and Parachute

To liven it up, I again called on Dave.

Inside the Box (Or You Can Just Skip to Out-of-the-Box Fun Part)

So, as I said, I was thinking about EMR cost, value, experience, and transformation, and then stumbled on The Experience Economy, in which Joseph Pine II and James Gilmore distinguish among five levels of customer value (see below).

Which of the following kinds of product value can an EMR deliver?

That of:

  • Undifferentiated stuff (commodities: flour, gas)
  • Tangible things (goods: vehicles, furniture)
  • Activities executed for a customer (services: tax returns, dog walking, legal services)
  • Time spent with a customer (memorable experiences: theater, tour guide)
  • Demonstrated customer outcomes (transformations: personal trainer, psychiatrist, productivity improvement)

If EMRs are interchangeable (many practically are, though not yet from an interoperability point of view), they are commodities. Delivered as a complete system of software and hardware, an EMR resembles a tangible good. And some EMRs are delivered as a service over the Web, though many such services also eventually become commodities.

What about the value of experiences and transformations created during implementing, going live, and optimizing an EMR workflow system?

Recent EMR market trends highlight EMR experience, or usability, as a key product differentiator. Is an EMR easy, even fun, to use?

Further, what about the ability of a EMR to transform?

Going Live with an EMR is as Easy as Jumping Out of an Airplane

“It was a beautiful summer day in northern California - 1982. I was about to embark on the adventure of a lifetime. Our instructor was an ex-Vietnam jumper and had thousands of jumps behind him. Jumping was his life. He had been teaching people how to jump for years, five days a week at this location. He had never had a mishap. It would take almost a full day of training for each of us to gain the knowledge and the confidence we would need to step out of that airplane…”

So began a new chapter in Dave Hubbard’s life. To give away the ending, Dave’s chute did not open, but he survived to tell his story. Since that moment, Dave has told and retold his story, applying it to a wide variety of subject matter across scores of industries, to inspire and motivate.

An All-American collegiate athlete who played professional football in the 1970’s for Hank Stram of the New Orleans Saints and then the Denver Broncos, Dave is familiar with healthcare professionally (serial entrepreneur) and personally (after all, he broke his back jumping out of a perfectly good airplane!). Combining an appreciation of team spirit and performance with an understanding of information technology, Dave has inspired thousands to better confront their fear and prepare for success.

Adopting an EMR is increasingly about the total EMR rollout and go-live experience rather than merely achieving specific EMR functional goals. (And skydiving is all about experience; after all, you’re already on the ground.) EMR rollout and go-live experience includes two components: emotion and meaning. “We were afraid but also eager and curious; we confronted our fears, overcame all obstacles, and grew individually and as a team.” This process of working through emotion to meaning is the great intangible key to EMR rollout and go-live success.

Analogies between skydiving and adopting an EMR include:

Murphy’s Law applies to both. (”Anything that can go wrong will go wrong.”) Therefore imagine everything that can go wrong to prevent it; survive problems before they happen.

Preparing to go live with your EMR is like packing your chute. (And your implementation coordinator is like your jumpmaster!)

Dealing with anxiety about taking a step into the relative unknown (to you) is like making your first move out the airplane door. (“Feet out! Get out! Go!”) Your EMR vendor, like your pilot, will do everything possible to drop you on the target, but it’s up to you to steer and land. It’s a cooperative effort.

Surviving the inevitable ups and downs (and then ups) of implementing, training, and getting back to previous levels of productivity takes mental preparation that begins *before* you set in motion events for which there is no “Undo.”

Make Dave’s story your story…

“It was a beautiful summer day in my hometown - 2010. I was about to embark on the adventure of a lifetime. Our instructor was an ex-EMR user and had hundreds of EMR implementations behind her. Helping people make the jump to an EMR was her life. She had been teaching people how to use EHRs for years, five days a week all over the nation. She had never had a mishap. It would take almost a full day of training for each of us to gain the knowledge and the confidence we would need to use our new EMR to see our first patient…”


What’s my point?

The true value of an EMR (workflow system) is not in specific product features and services available, but rather, it is in the transformational experience that can happen to you and your medical practice.

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One Comment

  1. chuckwebster
    Posted October 27, 2009 at 2:46 pm | Permalink

    I have some posts on the relevance of aviation human factors to EMR workflow and usability on this blog. This upcoming presentation looks so interesting that I’m posting this information as a comment to each of my aviation-related posts. I won’t be able to make the presentation, but would love to hear from anyone who does.



    Leadership Summit on Project and Portfolio Management for Health

    12/03/2009 - 12/04/2009

    Boston Park Plaza Hotel

    Boston, MA

    OUTSIDE INDUSTRY: Analyzing the Success of the Aviation Industry’s Implementation of Crew Resource Management


    With tens of thousands of daily flights in the U.S., airline flight crews make millions of life-sustaining decisions every day. Crew Resource Management has opened the lines of communication, leveled the hierarchy, standardized operating procedures, and engaged the entire organization in the airline safety equation. As a result there have been zero fatalities on major carriers in the U.S. since 2001.

    Acquire practical knowledge of effective interaction within high performance teams.

    Explore an interactive model of six risk-management skills.

    Team Building
    Workload Management
    Decision Making
    Situational Awareness

    Apply those skills to situations outside the airline industry.

    Captain Art Samson
    Delta Air Lines (Retired);
    Author, The Captains’ Airline; Cruising Toward Disaster

    Art Samson spent thirty five years as a professional aviator, trainer, and evaluator in both military and airline environments. At Delta Air Lines he was instrumental in developing and delivering Crew Resource Management training to ten thousand pilots and eighteen thousand flight attendants. During the twenty years such training has been provided, accident rates have plummeted and fatalities attributable to the airline have fallen to zero.

    Samson parlayed a leadership scholarship into an English degree at Lewis and Clark College in Oregon. While there, he captained the swimming team and powered them to consecutive conference championships before graduating in 1968. He became a Naval Aviator in 1970 and immediately returned to Pensacola, Florida as a flight instructor. Later he commanded countless sensitive reconnaissance missions throughout the Pacific and Indian oceans before commencing his airline career in 1977.

    As an airline pilot, Captain Samson served as a check airman and director of Delta’s Pilot Instructor School in Salt Lake City. While there he completed a Master of Professional Communication degree at Westminster College. He created and taught an Aviation Human Factors curriculum at the college.

    Art now resides in Bend, Oregon where he writes, consults, and lectures. His first novel, The Captains’ Airline, will be published late in 2009.

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