My last two posts have focused on some of the areas you need to think about when bringing up any of the more advanced clinical applications, like CPOE. Both your medical and nursing staffs will be greatly impacted by the infusion of this type of technology.
To be successful, you need to build a solid foundation of shared leadership in your organization. That foundation needs to include a strong physician leadership component, with nursing and other areas represented. My first charge to anyone considering moving a physician order entry system forward is to build a strong Medical Informatics Committee.
In order to accomplish the task, I would recommend talking to your Medical Executive Committee (MEC) and discuss with them starting a sub-committee within the medical staff to be the voice needed for these types of systems. If you don’t have a strong medical leadership group, look across your medical staff and choose physicians based on how they can help. Don’t just go get four or five physicians that are easy to work with! Get the physicians that you know will be vocal or have issues as the project moves forward. Get physicians that see family patients and specialists. Get physicians young and old, or ones that may have more at stake in the process, like hospitalists. The more representative of the overall medical staff you can make it, the better off you will be in the long run.
In our process, I asked the MEC to create a sub-committee to meet and report up to them and then to the medical staff as a whole. Once they agreed to that, we got busy recruiting physicians, and our Chief of Staff selected physicians to be on the group for us. We have an orthopedic surgeon as the chair of the committee that includes a family practice physician, an OB/GYN, a general surgeon, the CIO, CNO, CEO, Director of Pharmacy and an IT Clinical Analyst running the project. These four physicians all have varying years in their fields at Duncan Regional. They are not “yes” men or women and — although vocal about how, when, why and where — they want to help make the product as friendly as it can be. They want it to succeed.
Remember, these physician members will get an ear full from the other medical staff, but they know more today about how to work within the medical staff than you can learn in 30 years. That is their world, no matter how much you think you know it. You are looking to build a committee with credibility within your medical staff, so my recommendation would be to avoid physicians that are already EMR users in their offices and are extremely vocal about how well it works. Most of the time, these physicians don’t have the credibility you need in this group.
Once you select your potential committee, meet and discuss what your organizational goals are and how they can help. Define the mission of the group and set the schedule for meetings based on what the physician members can accommodate. Our meetings are bi-weekly, 7 AM, Monday mornings — Ouch! The more you can work with the physicians, the better your committee will be.
In my next post, I’ll present how our committee functions and discuss some of the issues they help us work through. Until then, build your foundation!