The person leading an Electronic Medical Record (EMR) implementation must know both the clinical and IT terrains. Since these two sets of knowledge don't ordinarily come in the same individual, who is best prepared to lead the EMR implementation effort, a clinician or a techie? I vote firmly for a clinician. Here's why.

At its heart, an EMR implementation should be a clinical and business processes undertaking, not an IT project. While an EMR crucially depends on technology, the ultimate purpose is to advance the quality and efficiency of care provided by people for people. The essential  knowledge underpinning an EMR is an intuitive grasp of the flow of the clinical enterprise: how to think, what to ask, how to decide, how to plan, execute and document. Next in line of importance is understanding the requirements of the complex business environment of health care. Then comes technical knowledge: how to exploit the rich computer systems toolkit to capture and enhance the flow and requirements.

This is NOT to say that technical knowledge is unimportant. It is essential for an EHR implementer to grasp the core concepts of networks, client-server, databases and reporting. When I began my transition from practicing psychiatrist to EMR implementer, I identified my computer naïveté to be a serious deficiency. So I promptly  enrolled in the introductory computer science course at a local college. I learned about hardware, networks, operating systems, reporting… I even became competent at very basic programming. On my own, I studied databases and taught myself MS ACCESS. I participated in many IT meetings. With focused effort, I learned enough to be an effective member of our IT team. To my surprise I found that computers are great fun – and very useful.  

I have talked with many people embarking on an EHR implementation. I routinely ask, “ Is it easier to teach a clinician the technical side or a techie the clinical side?” The answer is always, “It’s easier to teach the clinician.” What's your vote?