The Coach Every Physician — And CIO — Needs

Meaningful Use, ICD-10, increased security, ACOs, big data and other similar challenges just keep coming. And yet, in my opinion, our most significant challenge remains physician engagement and adoption.

Physicians are by far our most difficult customers. From their perspective, they need the tools we deliver to work and work well, every time, all the time. They see the EMR/EHR as a tool that should help them deliver better, safer care in less time. However, learning to leverage the EMR/EHR is like learning an entirely new language (paper process versus electronic process). As CIOs, our challenge is to help the physicians through the learning process so that they become more effective and efficient in the new digital healthcare arena.

We have all heard and seen different approaches to physician adoption of the EMR/EHR. I can safely say I have tried the majority of these methods with varying degrees of success. The most successful strategy I have found to date is the use of physician coaches. These physician coaches serve as a catalyst for physician training, from preconversion planning and coordination to conversion support and post-conversion optimization. These coaches act as educators, with or without direct clinical experience, but with significant expertise in the use of our EHR and physician workflow (both acute and ambulatory). They understand the optimal design of the EHR that will ensure optimal workflow for the physicians regardless of their specialty. They are excellent listeners with extraordinary patience.

During preconversion, these coaches participate in the development and delivery of the learning and behavior change management plan as well as online education, while monitoring and reporting milestones as they are reached. They also serve as a crucial link between all key stakeholders. To maximize the physician experience, coaches provide concierge-type services during the preconversion phase. They can be found in our physician lounge orienting users to the EHR system, answering questions, and walking through specific workflows. Our coaches are also available to meet face-to-face with key or difficult-to-reach physicians on rounds or in their offices.

During the conversion period, coaches provide dedicated, at-the-elbow support to physician end users. Post-conversion, they continue to provide dedicated, at-the-elbow support, as well as refresher courses and change management support.

The improvement in our CPOE and electronic documentation measures at NCH has been significant in just the few short months we have had these coaches in place. We have seen physician adoption and engagement increase by roughly 5 to 10 percent. Our coaches have been able to bring direct, unbiased feedback from even our busiest physicians back to our optimization team. We are now four weeks from our mandatory date for our physicians to be digital, and our numbers are increasing daily. The training schedules are full, with physicians wanting to get on this rapidly moving train.

This initiative is about providing dedicated support to physicians before, during, and post conversion; providing a comprehensive support method that successfully prepares end users to effectively utilize the EMR/EHR to deliver high quality, efficient care.