I quoted this CIO in my previous post about EMR Motivations, but I also thought that Neal Ganguly provided some interesting analysis of the time frames involved with selecting, implementing and using an EMR. Plus, he takes it one step further and adds in the time frames to get the EMR regional extension centers in place as well. Check out the EMR timelines:

Hospitals / Physicians: It can take 3-6 months to evaluate and select a system and then it takes 18-24 months to install a hospital clinical system. It takes 2-5 months to properly install a physician EMR. It can take 6-12 months or more to work out the kinks and become productive on such systems.

The talent pool to accomplish this work is spread thin. Hence the extension center concept. However, it can take 3-6 months to establish centers operationally (find space, recruit staff, establish curriculums, etc), and then 3-6 months to recruit and train people to a reasonable standard to make them minimally effective. So optimistically, it would be 6-12 months from inception before the first trained individuals emerge from those centers – and really, 12-24 months before they have some of the real life experience needed to be effective.

It really struck me when Neal compared the time to get a regional extension center going and their inability to really support those interested in ARRA stimulus money.

I’ve been thinking quite a bit lately about the impact of the EMR stimulus money and how it’s changed the EMR world. One of the big changes is the motivations people have to adopt an EMR. With $36 billion of stimulus money, things have changed. I even went so far as to create a post called “EMR Is About the Money.”

Turns out that CIO, Neal Ganguly, agrees with me, but described it in a much more politically correct way in his listing of the EMR drivers:

• Physicians: Primary Driver = Stimulus dollars; Secondary Driver = Easier access to data; Tertiary Driver = Better outcomes / continuity of care
• Hospitals: Primary Driver = Stimulus dollars; Secondary Drivers = Strengthen physician relationships / Fear of reduced reimbursement; Tertiary Drivers = Better outcomes / continuity of care
• Government: Primary Driver = Reduce costs by eliminating waste and redundancy; Secondary Driver = Better outcomes / continuity of care; Tertiary Driver = Better data to analyze and drive ongoing health reform.

Does anyone disagree with these items? I’d love to hear it in the comments.

My only comment is that government doesn’t seem to have any drivers. To me it seems like they were just given a bunch of money for EHR and now they’re trying to figure out what to do with it.