Electronic medical record implementation in a large healthcare system from a leadership perspective

Abstract

Background: Information on the use of change management models to guide electronic medical records (EMR) implementation is limited. This case study describes the leadership aspects of a large-scale EMR implementation using Kotter's change management model.

Methods: This case study presents the experience in implementing a new EMR system from the leadership perspective at King Abdulaziz Medical City, a large tertiary care hospital in Riyadh, Kingdom of Saudi Arabia. We described the process of implementation and outlined the challenges and opportunities, throughout the journey from the pre-implementation to the post-implementation phases.

Results: We described the corresponding actions to the eight domains of Kotter's change management model: creating a sense of urgency, building the guiding team, developing a change vision and strategy, understanding and buy-in, removing obstacles, creating short-term wins, building on the change and anchoring the changes in corporate culture.

Conclusions: The case study highlights that EMR implementation is not a pure information technology project but rather is a technical-based complex social adaptive project that requires a specific set of leadership competencies that are central to its success. It demonstrates that change management models might be useful for large-scale EMR implementation.

Keywords: Electronic medical record; Leadership; Leadership approach; Models of change.

Fig. 1

Readiness assessment tool used during the electronic medical record (EMR) implementation process. The tool captured critical tasks needed for implementation and was used across different medical and operational departments. The tool was shared with hospital leaders and department leadership frequently to track preparedness, peer-feedback, and expedite progress. Completed tasks were color-coded green, tasks in progress were color-coded yellow, and deficient tasks were color-coded red. When more than 95% of project tasks were green color-coded in any unit, that unit was considered ready. Overall, all essential project tasks were green color-coded at the time of the big bang implementation (go-live)