Doctors at the University of Illinois Medical Center in Chicago used to hide patients’ medical charts under hospital beds. Better that than let a precious chart descend to the bureaucratic black hole known as the medical records storage department. Let the chart go and a doctor might never see it again. So the doctors would hide it until they were done with it. "We called it hoarding records," says Dr. Bill Galanter, who used to hide his patients’ records in his office rather than under their beds for fear the mattresses would get changed.

Now those records are electronic and accessible from anywhere in the hospital or the Internet. Hard copies don’t exist anymore. When the medical center built its new outpatient center in 1997, it did not include a records storage room. "We burned the bridge. No paper," says Joy Keeler, the IS leader of the medical records conversion, drawing out those last two words while boring a friendly hole in your forehead with her intense brown eyes.

Keeler is a born campaigner, a small, thin wisp who burns very brightly. For five years she has been pounding the halls of the motley scattering of old and new buildings that compose the medical center, trying to convince doctors to change the way they practice medicine. If that sounds like a grandiose goal, it’s because she had no choice. She could not do her job without first changing how doctors did theirs. Change management is important to any system implementation, but it’s everything in a hospital. There is no value to an electronic medical record if doctors don’t use it. It is an all-or-nothing proposition.

The University of Illinois Medical Center won an Enterprise Value Award because of a brilliantly executed change management strategy, through which it managed to get the toughest users on the planet to lift their heads up long enough from the work of saving lives to change the way they deliver care to patients. Most believe they can do their work better and more cost-effectively than they did before the system. Computer system value doesn’t get much better than that.

A Big-Bang Implementation

Change is hard. Despite their complaints about paper medical records, doctors really don’t want to give them up. Only 4 percent to 15 percent of hospitals nationwide have electronic medical records today, according to various industry estimates. It’s still faster to scribble a note than it is to sit at a computer and enter data.