Challenges of an EMR Implementation in a Merged Health System

Posted by Oxford Healthcare IT Consultant on Jan 17, 2015 7:00:00 AM

EMR implementations can be daunting. But what makes the process even more complicated is when a health system is also undergoing a merger in addition to an EMR implementation. One of Oxford Healthcare IT's consultants shares with us how she approaches such a challenge. 

As consultants most, if not all, of the EMR implementation projects we are engaged on involve working in a “matrix” environment with our clients.  Resources assigned to the various project teams come from IT, operations, external consultants, and the EMR vendor, and report to the project director and project manager(s) to accomplish the project’s tasks.  However, these same project team members also report to their own directors and managers, whether in the healthcare organization, the vendor, or external consulting firms.  Achieving the project’s goal requires coordination across reporting lines and project leadership is dependent on others who report to a different boss.

There are always challenges when faced with the matrix environment which must be overcome to be successful in achieving the project’s goals.  There can be misaligned goals, conflicting loyalties, confusion about roles and responsibilities, and delays in decision making.  As consultants, we have been met with these challenges over and over again.

Now picture these same challenges with the added complexity of an EMR implementation project in a recently merged healthcare system, such as an organization with three hospitals in a city merging with another two-hospital organization.  Or, a large healthcare system headquartered in one state acquiring multiple hospitals in other states.


The above mentioned challenges of misaligned goals, conflicting loyalties, confusion about roles and responsibilities, and delays in decision making are even more likely, as these organizations may not have worked together previously and may, in fact, have been competitors.  Also, a potential new source of conflict is added - the individual organization’s cultural differences.  These cultural differences can create significant challenges for the project.

For example, suppose your EMR project involves the implementation of computerized physician order management (CPOM) with standardized processes, workflow and functionality across the newly merged organization.  This would require significant physician engagement from all facilities in the merged association.  The challenges arise if there are cultural differences in how physicians in one pre-merger group are engaged with leadership in the organization vs. the other pre-merger group.  The first organization may have employed physicians who are familiar, if not comfortable, with working under centralized leadership with standardized processes already in place.  The culture of this organization differs from the other organization, which does not employ physicians, but instead has affiliations with multiple physicians and/or physician group practices.  Physicians working with this organization each have their own standards and processes and are not used to collaboration with others.

When these key elements have not yet been established by the start of the project, how can you be successful?

Download our EMR consultant guide below and discover how to keep your EMR project on track within a merged health system. 

EMR implementation guide


Topics: Healthcare IT