A gigantic task
The implementation of the healthcare platform is a gigantic project which will change the course of healthcare history on Zealand. The aim of the project is to purchase, customize, implement and standardize an entirely new system for working and documenting in all of the hospitals in the Capital Region of Denmark and Region Zealand.
Interview with Henning Trier, head of IT development, Region Zealand
It has to be easier to do your work well. And so Region Zealand and the Capital Region of Denmark have joined forces to introduce the healthcare platform. A gigantic technical and change management project, which simply put involves implementing an American IT system at 17 hospitals across two regions.
The healthcare platform is divided into three subprograms. The shared track: The healthcare platform – and two subprograms in each of the two regions. A total of about 500 people are working together to implement the healthcare platform.
And the implementation of the healthcare platform will fundamentally change how healthcare professionals perform their jobs. The system is a new way of organizing the encounter with the patient, treatment and the management of the hospital. The healthcare platform unites all information about each patient in a single electronic medical record spanning the two regions. This gives healthcare personnel a better overview, greater patient safety and fewer errors during a course of treatment.
Until now, Region Zealand and the Capital Region of Denmark have had separate IT systems, and in both cases, the primary information about the patients is registered in a text record which often contain quite a lot of text, which can be difficult for personnel to process quickly in a hectic work environment. The healthcare platform is introducing a system based on structured data, which is intended to make it easy for the clinics to get an overview of the patient’s medical records quickly.
And so work processes have been analyzed, with assistance from healthcare personnel, in order to improve and standardize the approach to treating patients across the two regions. In a democratic process, nurses, chief consultants, orthopedic surgeons and many, many more have voted for and against solutions with green and red cards – and have thus helped customize the American system to function in the Danish clinical reality. This has resulted in a patient medical record where it is no longer necessary for personnel to log prose descriptions of injuries or symptoms, for example a broken leg or a frozen shoulder. Instead, they tick boxes in a form, with the patient sitting right next to them.
“It’s a huge change management project, and we’re not at the finish line yet. But this is where we can really make gains: we save time, fewer people need to be involved, and it increases patient safety,” explains Henning Trier, head of IT development in Region Zealand.
The American company Epic won the tender. Trier has only praise for the Americans, who have shown themselves to be extremely professional and willing to work in an agile process. Involving stakeholders, particularly doctors, is an important part of Epic’s concept, because without their involvement, implementing the system will be difficult. And so healthcare councils from all occupational groups have been asked to discuss the best way to work for each specialization. This was one of the first parts of Epic’s implementation. As Trier explains:
“In choosing Epic as a supplier, we also purchased an implementation concept with a great deal of focus on making sure the solution has local legitimacy. That’s a good starting point for success.”
It goes without saying that there are legions of challenges in such a large IT project, but one thing Trier has noticed in particular is that getting people up to speed was a slow process. It took five months to get people certified, during which the project practically ground to a halt. As Trier tells it:
“Epic delivers a standard software project. Once it’s decided what extra features a department needs, they need to be added on, but to get access to customizing the system, you have to be certified as a ‘builder’ by Epic. This is a requirement they included in the contract documents: They wanted to make sure that we knew what we were doing. Selected employees were sent on training courses and had three tries to pass an exam. Some of them didn’t pass, and so we had to send new ones for training.”
All of the builders will be affiliated with a new form of system administration. With the old medical record system, you called the supplier and asked them to change things. Now the regions can make these changes themselves.
“We’re saving a lot of money, but we will have to introduce a completely different form of system administration. The builders will be sent back to the regions when the program is finished, so that they can continue developing the system,” explains Trier.
When the individual departments have finished their part of the system and the hospitals are up and running, there will be new ballots with red and green cards if something doesn’t work, because the goal is to maintain standardization across hospitals and regions.
Project management challenges
Managing an enormous project like the healthcare platform is not for the weak of heart. Collaboration between two regions and 500 people involves a lot of cultural and professional differences, which has resulted in a fairly high rate of turnover. In 2014, Region Zealand assigned 12 of its own project managers to the project – two years later, there are just two left. Geography has been a contributing factor, as the project managers suddenly had to drive back and forth between Sorø and Copenhagen 3-4 times a week, an hour’s drive each way. What’s more, they became part of a large supplier organization, which requires a high degree of self-management, and that the employee goes back to his line manager in the region when challenges arise. The upshot was that the head of IT development has had to recruit external resources – with varying degrees of satisfaction so far:
“It’s hard to find consultants who take ownership from day one. At the same time, the project managers often fall into one of two categories: either they are extremely skilled professionally and have no personnel management experience, or vice versa. If you’re a freelancer, you have to be extremely skilled. That’s my opinion, but it’s not always the case. It’s been a mixed bag, and I’ve had to send some of them home.”
At the same time, Trier finds that consultants are bad at saying no. When a consultant is performing well, Trier delegates more task to him or her and asks if they can cope with more.
“They say yes because they feel like they have to – but often I end up with bad quality work delivered. Very few say no, and it’s natural, but it’s not professional. I expect people to be able to draw the line.”
Facts about the healthcare platform
- The healthcare system will be implemented at all hospitals and institutions under the Capital Region of Denmark and Region Zealand by 2018
- Region Zealand will begin implementing the healthcare platform in November 2017
- The supplier Epic supplies solutions to over 1,100 hospitals all over the world
Name: Henning Hoepfner Trier
Education: MSc from the University of Copenhagen
Title: Head of IT development, Region Zealand
Has worked in IT since 1998, including 8 years in the private sector and the last 9 years for Region Zealand. Responsible for all of the region’s IT projects, and has a special task as head of IT development in connection with the healthcare platform. Is responsible for helping to ensure that it becomes a success, and acts as the intermediary between the program and the executive management of Region Zealand.