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Ken Farion



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    OS08 - The Road to Digital Health Adoption (ID 12)

    • Event: e-Health 2019 Virtual Meeting
    • Type: Oral Session
    • Track:
    • Presentations: 1
    • Coordinates: 5/27/2019, 03:45 PM - 04:45 PM, Area 4
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      OS08.03 - A Novel EMR Benefits Realization Program in the Canadian Context (ID 400)

      Ken Farion, CHEO; Ottawa/CA

      • Abstract

      Purpose/Objectives:
      Implementing an enterprise-wide, integrated EHR solution is one of the largest and most complicated investments any hospital or health system can make to transform care and achieve better outcomes. Formally quantifying these benefits requires a structured approach against pre-established targets. As a small, independent, non-case costing academic pediatric institution in Canada, we encountered some notable barriers as we set out to establish a Benefits Realization governance structure and program that would achieve targets delineated in our Board-approved Total Cost of Ownership forecast. First, quantifiable Benefit Realization has been infrequently explored internationally in publicly funded systems where no competitive advantage to build/expand business and market share exists. Financial benefits in our environment must be gained through decreasing demand for services and efficiencies resulting in decreased costs, whether FTE’s, supplies or infrastructure. Next, Benefit Realization has typically been evaluated as part of a large system initiative as opposed to at a local level. Finally, most Benefits Realization programs succeed as a fully resourced, parallel structure to the implementation and operations team; this was not possible in our environment.


      Methodology/Approach:
      Based on best practices from other organizations, but tailored to the fiscal realities of our institution, we created a Benefits Realization governance model that was clinically led yet grounded in financial and statistical rigour. This structure was embedded within existing operational committees and targeted quantifiable clinical, operational, and academic benefits that aligned with the organization’s existing strategic directions. Where relevant, benefits that aligned to specific General Ledger cost centers were tracked and tallied against our targets. A graphicly-pleasing quarterly report to the Board of Directors dually served as accountability and as a key communication and engagement tool within the organization.


      Finding/Results:
      By creating a governance structure embedded within operations, we garnered benefit ownership and buy-in to achieve the targets. Further, by driving nine targeted core benefits while also collecting and evaluating smaller incremental benefits with rigor, the organization could rally around the effort, further reinforcing the vision and mission of both the EHR implementation and the hospital strategic directions. Tools were created that fostered operational leadership and engagement and allowed Benefit Realization to fundamentally link to and drive corporate strategy. The Board report template was repurposed to support other communication channels. Through initiatives solidly linked to the General Ledger, we demonstrated efficiencies through permanent cost reductions to meet the Benefit Realization targets within our Total Cost of Ownership. Further, we linked these initiatives to improvements throughout the organization to demonstrate the power of an integrated EHR as the foundation for change.


      Conclusion/Implications/Recommendations:
      Formal Benefit Realization following an EHR implementation is often a requirement and can be seen as an academic exercise parallel to the project and operations. However, by embedding the governance structure and linking solidly to the strategic directions of the organization, large scale and smaller incremental benefits can fuel the transformation. By sharing stories, fostering buy-in, and ensuring rigour, smaller organization can meet their Benefit Realization goals across clinical, operational, academic, and financial perspectives.


      140 Character Summary:
      Benefit Realization strategy within existing governance and linked to corporate directions to identify clinical, operational, academic, and financial benefits