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Together they are powerful beyond imagination."

- Albert Einstein

Learning Tech Things At My Doctor’s Office

Sam Bridegroom  |  Posted Monday, December 9th, 2013 at 10:52:48 AM

I had an appointment late last week with one of my specialists; it turned out to be more enlightening on the technology/customer service front than anything else.

My appointment was scheduled for 8:20AM, arrive 15 minutes early at their request. Wasn't called back to see the doctor until 8:55AM. Needless to say, plenty of time to stew in the waiting area. As I look around the rapidly-filling room, I see a  2'x4' sign (along w/ several 8 1/2x11 sheets) being prominently displayed:
"We are currently upgrading our computer system to better serve you. Your patience is appreciated."

As they finally call me to the check-in/registration desk at 8:40, I voice some of my displeasure with the wait for what was an early appointment (I was pleasant about it). The response I got from the reception person was "I'm sorry, but I just got here - thank you for your patience." The tone got pretty terse from her, which actually kind of surprised me. It was early, I opted to not engage.

I finally get back to the exam room at 8:55, greeted by the nurse who takes BP, etc - and quickly mentions the the fact that they've got new systems. And it's been painful. And that I should be glad I was here this week versus say a week ago - when it was really bad.

My doctor arrives - and the first thing he says to me after hello is an apology for the horrible delay - due to the new systems. He knows what I do (and that fact that I do a lot of it for another healthcare system), so I started asking questions about what was going on (because I like to learn from others' pain). As a result, I think he was a little more forthcoming with information. That, and the fact that he was a part of the selection team for the solution (and felt the need to explain). Either way, I learned some things.

Short version (and in my doctor's words):
  • The multi-site "mothership" for his medical group is implementing a new EHR across all practices/systems in their network.
  • They chose a cloud-based solution - based on feedback, reviews, and other evaluation criteria.
  • This practice is an alpha site for their full implementation.
  • Implementation was very rushed and not well planned.
  • They were not prepared for the front end load requirements at the registration point; encountered "real staffing issues". My question was "wrong staff or not enough?" - a very quick not enough.

I shared with him a quote that I borrowed from John Halamka's blog - I read a lot of what he writes because I always learn something. There are no truer words about system implementation that I've ever seen than these:
"If you go live months late when you're ready, no one will ever remember. If you go live on time, when you're not ready, no one will ever forget."

They are definitely in the never forget camp to be sure.

There are lots of takeaway lessons from this trip:
  • Rushed implementations never work. Even if you're an alpha implementation, it should be a meticulously planned event and treated like the finished product.
  • The staffing issue/response screams to me that nobody actually did a pilot/test scenario, in something like a "model office" to see if it was in fact a viable solution before making the vendor selection.
  • This is why you sweat the small stuff when making your strategic decision - overlooking what may seem small might have the potential to create very real pain.
  • Do not underestimate the value of training, and lots of it. I got the distinct impression that even a few weeks into the effort, there was a lot of end-user discomfort with the system.
  • Patients (read: customers) don't want to read or hear excuses - because computer conversions are not the patient's problem or concern. They already have concerns, that's why they're in the office to begin with, so don't compound it with frustration. And don't advertise it to the public, because doing so allows it to be a crutch for staff. At least that's what I saw.

In a previous life, I used to work on bank system mergers/conversions (five of them to be exact); while they're different kinds of businesses, the concepts associated with converting systems and how one goes about it are very much the same. Customers didn't want to hear how difficult the conversion efforts are/were to undertake, they just want to be sure their financial affairs were in good hands. Sweating all of the finer points mentioned above was absolutely required to be successful, all the way down to making sure there are plenty of "reinforcements" at the front line where customers are met.

Before I left, my doctor assured me that I'd see a very noticeable difference at my follow up appointment in February. I'm looking forward to finding out if he's right (not necessarily looking forward to the appointment).

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