Healthcare Quarterly

Healthcare Quarterly 22(3) October 2019 : 73-83.doi:10.12927/hcq.2019.26012
Electronic Health Record

Going “Big Bang” into an Electronic Health Record: Four Recommendations from Leading a Dynamic Academic Health Sciences Hospital Through Transformational Change on Time, in Scope and Within Budget

Tara Coxon, Andriana Lukich, Agnes Bongers, Winifred Doyle, Thomas Stewart, Danielle Sanagan and Chris Hayes


At 4 a.m. on December 2, 2017, St. Joseph's Healthcare Hamilton – a multi-site, clinically diverse, tertiary academic and research hospital – deployed an electronic health record (EHR) system across the organization using a “big bang” approach. This effectively required all inpatient, emergency and many ambulatory services to put down their pens and document everything electronically at one moment in time without skipping a beat in providing excellent clinical care. The hospital leapt from the bottom to nearly the top of the internationally recognized measurement for EHR adoption – on time, in scope and within budget. This article presents the leadership's view on essential lessons learned with key recommendations for healthcare systems seeking successful implementation with this approach.



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