Tuesday, June 3, 2008

EHRs for Non-Owned doctors - Roles and Responsibilities

As promised, it's June and BIDMC has begun the implementation of our Software as a Service Electronic Health Record for non-owned clinicians. As we "market" the practices on the idea of using a hospital subsidized electronic health record, we need to have all the details ready - the costs, the service levels, and a crisp definition of the roles and responsibilities of each member of our team. Since the project is comprised of 5 insourced and outsourced groups working seamlessly together (BIDMC, Massachusetts eHealth Collaborative, eClinicalWorks, Concordant, and Third Brigade), we need to have unambiguous agreement among our teams as to who will do what, who will be accountable and who will communicate the handoffs.

To ensure a perfect understanding among all stakeholders, we created a Roles and Responsibilities Matrix. There are two aspects of this work that are generally useful to other hospital systems implementing electronic health records.

1. We've defined all the component parts of an implementation, from training, to desktop support, to security

2. We've classified the roles as
Responsible - the person or team who does the work
Accountable - the person or team who reports on the work and is ultimately held responsible for its completion
Consulted - the person or team who provides an opinion when consulted as a stakeholder
Informed - the person or team who is told about the decisions made and progress achieved

Each of the 5 team members will sign of on the matrix so that there will be no misunderstandings or finger pointing.

When implementing large, complex projects, adding extra details like a roles and responsibility matrix prevent future problems. Assumptions can get teams into trouble. Well documented understandings keep everyone friendly. I hope you find it useful.


Dean said...

Would you consider implementing a BCP/DRP with this project?

My assumption at this stage is that something which seems this critical would also be part of your BCP?


John Halamka said...

Business Continuity and Disaster Recovery are already part of the design.



The Critical patient said...

Is it OK to use the spreadsheet, with attribution of course?

John Halamka said...

Absolutely. All content on my blogs may be reused in any way you wish.