1st Edition

The Lean Electronic Health Record A Journey toward Optimized Care

    300 Pages
    by Productivity Press

    298 Pages 48 B/W Illustrations
    by Productivity Press

    298 Pages 48 B/W Illustrations
    by Productivity Press

    The Electronic Health Record (EHR) is a reflection of the way your organization conducts business. If you’re looking to make lasting improvements in the delivery of care, you must start with looking at the system from your patient’s perspective to understand what is of value and what is simply waste. When you begin seeing in this way, you’ll begin building in this way. When you begin building in this way, you’ll begin driving improvements in your care delivery. Only then will your EHR be able to support lasting improvements, driving better patient care and outcomes at lower costs. 

    Healthcare organizations are under increasing pressure to improve on all fronts. This can be achieved, but only by changing the very way we look at care. No longer can we look at care just from the organization or provider’s perspective; we must start with the end in mind – the patient. Compelling case studies, discussed throughout this book, demonstrate that modifying processes and workflows using Lean methodologies lead to substantial improvements. These changes must be undertaken in a clear, consistent, and methodical manner. When implementing an EHR based on existing workflows and sometimes antiquated processes, organizations struggle to sustain improvements.

    Many organizations have deployed an EHR and now face optimization challenges, including the decision to move to a new EHR vendor. The financial implications of upgrading, optimizing or replacing an EHR system are significant and laden with risk. Choose the wrong vendor, the wrong system, or the wrong approach and you may struggle under the weight of that decision for decades.  Organizations that successfully leverage the convergence of needs – patients demanding better care, providers needing more efficient workflows and organizations desiring better financials – will survive and thrive.

    This book ties together current healthcare challenges with proven Lean methodologies to provide a clear, concise roadmap to help organizations drive real improvements in the selection, implementation, and on-going management of their EHR systems. Improving patient care, improving the provider experience and reducing organizational costs are the next frontier in the use of EHRs and this book provides a roadmap to that desired future state.

    Part 1: The reason for action – why should we change?; Chapter 1: Always start with the patient; Chapter 2: Take care of ourselves before we take care of others; Chapter 3: Dollars and cents; Part 2: The blank slate – Installing a brand new EHR system; Chapter 4: Requirements Gathering; Chapter 5: Design Phase; Chapter 6: Testing Phase and User Acceptance; Chapter 7: Go-Live; Chapter 8: Optimization; Part 3: Houston, we have a problem – what to do with an existing EHR system; Part 4: Lessons Learned … and learned again; Chapter 12: Do not replicate a broken current state into a new EHR; Chapter 13: Standardization is not optional; Chapter 14: Engage users and patients early and often; Appendix: Tools and Templates for use in lean EHR implementation


    Ronald G. Bercaw


    "For some reason we thought the Electronic Medical Records would solve all of our healthcare problems. So we misapplied computer solutions to solve problems of bad processes and rigid cultures. Lean management can help by engaging people in improving processes, identifying their real information needs, and making EMR truly value added."

    -Jeffrey K. Liker, PHD Author, The Toyota Way

    "Organizations that do not consider the workflows and processes for their EHR will never optimize or achieve highly reliable outcomes. HRO organizations align and invest in their informatics and Lean teams. These teams collaborate together can achieve the triple aim and effective use of the EHR, and happiness of users and patients alike. This book is an important demonstration of these methodologies."

    -Michael J. Kramer, M.D. – SVP and Chief Quality Officer

    "Kurt, Ron and Susan have a message: the Electronic Health Record (EHR) can help or hinder the healthcare delivery system. By following the proven methodology detailed within The Lean Electronic Health Record the EHR can be the enabler of better and coordinated care. A must read for doctors and administrators truly interested in putting the patient in the heart of healthcare."

    - Helen Zak

    "The Lean EHR is a clear, concise description of the use of Lean principles in a real-world setting. Written in a relaxed, personalized writing style, the authors successfully guide the reader through a detailed Lean process for a very complex project. It is an excellent resource for those teaching Lean principles in academia, as well as healthcare teams planning to implement a new EHR."

    -Gail Bullard, DHEd, MSHA, RN, LBBH, Lean Healthcare Program Coordinator, Ferris State University