Lessons Learned From Development of an Enterprise EHR Clinical Standard

Large health systems need ways to monitor practice patterns through EHR data as well as ship EHR content in a cost-effective and efficient manner. HCA Healthcare struggles with both of these activities given the individualized nature of the EHR install at each of its 180 acute hospitals. With a planned implementation of a more modern EHR system, HCA embarked on the daunting task of standardizing clinical builds and workflows to improve the enterprise’s ability to extract clinical insights from EHR data as well as alleviate maintenance burden, starting with a pilot at three sites. The project team encountered significant challenges in determining which builds/configurations should remain controlled at the corporate level versus those that should be managed at a local level. Change management struggles played a large factor in outcomes and speed of progress. Members of the project team will share these lessons learned from the efforts to define, build, and educate on the initial standard EHR build at the pilot sites that should serve as a framework for other health systems looking to achieve the benefits that can come from a standardized EHR environment.