A failed implementation, a return to paper, and an encounter with non-standardized data.
Not exactly ringing endorsements for the potential of IT in healthcare. In fact, these experiences would be enough to send most people running, but for three highly respected and accomplished leaders, it was a calling — a challenge to make things better.
In a recent webinar, our panelists — Sherri Hess, CNIO at Banner Health; Brian Patty, MD, CMIO at Rush University Medical Center; and Joel Vengco, CIO at Baystate Health — talked about how they answered the call, and provided practical advice on how IT and clinical leaders can partner to improve care delivery and increase user satisfaction.
As one might expect, it starts by identifying the key obstacles and working through them. And although there are many, one of the biggest culprits, according to Patty, is failing to involve clinicians in the EHR selection and implementation processes. It’s a lesson he learned — or at least observed — firsthand when he “walked into a firestorm” earlier in his career. After accepting a CMIO role, Patty learned that the organization had experienced a failed EHR rollout, and had to start from the beginning.
“It was a matter of talking to all the clinicians and the IT team and getting the two sides to talk to each other,” he noted. “It was a good learning experience.”
It opened his eyes to the gaps in communication and understanding that exist between clinicians and IT, and more importantly, helped him to realize that there’s a better way. His fellow panelists had similar epiphanies, with Hess being part of a department that abandoned a problematic nursing documentation system, and Vengco learning firsthand how challenging it is to work with unstructured data. Fortunately, all three have been able to leverage those experiences in their current roles.
Below are some of the key pieces of advice from the webinar:
- Focus on value. One of the key mistakes IT leaders made, according to Vengco, is speaking a language clinicians don’t understand. “Don’t just talk about the functions of a specific technology or capability; talk about the value it can bring,” he said. “Technology is never the silver bullet – it won’t make a physician’s day. But it certainly can provide value, and if you can talk about that, it can make a big difference.”
- Understand workflow. Developing a deep understanding of all the different workflows is critical; it’s also impossible for one person to do it alone. To that end, Patty created an associate CMIO program whereby physicians from multiple specialty areas provided key input based on user needs. “They’re using the system. They’re involved in those workflows. They understand the pain points and they can translate to analysts what needs to happen,” he said.
- Appoint ‘account managers.’ Similarly, Vengco had developed a team of business relationship managers, which he likened to ‘account managers’ who serve as representatives for clinical voices in the
- Be aware. According to Patty, one of the most common mistakes is failing to see, or acknowledge, the time constraints and stresses facing clinicians. “To be put on hold or not have an immediate response and get those issues resolved is highly frustrating,” he stated.
- Communicate the ‘why.’ The majority of clinicians got into healthcare to make a difference in peoples’ lives, said Hess. “We want to be the voice of the patients and we want to be able to spend time with them.” What they don’t want is to devote precious minutes to dealing with cumbersome tasks. As a result, “we can come off as being uncooperative at times. But it’s really because we’re looking out either for our fellow nurses or patients. And if we really understand why something is happening to us or to our patients, we can get on board.”
- Ask the right questions. A critical piece of that, she noted, is in communicating effectively, which means skipping open-ended questions like ‘what type of solution do you want,’ and instead asking about specific pain points, and addressing them.
- Do rounds. By having everyone from application analysts to engineers round, it enables those who work on IT systems to see “how their work translates and understand more empathetically what happens when a system is down, even for a few seconds, of if there are extra clicks,” said Vengco. “They get a sense of the urgency during those situations.” In addition, it prevents individuals from feeling isolated and can help everyone make sure “they’re part of the mission.”
- Observe solutions in action. What often happens, according to Patty, is a solution looks great when it’s in the shop, “but when we put it out, we find that it’s messing with somebody’s workflow.” By sitting with individuals and watching how they’re actually being used, leaders can learn how to make tools more efficient for end users.
- Work around clinicians schedules. It’s important to provide as much at-the-elbow training and support as possible when delivering training, added Hess. “We don’t expect nurses to go to classroom, and they shouldn’t. We should be delivering training at a time that’s convenient to them so they can optimize their time with patients.”
- Create relationships. A key challenge for many clinicians who have taken on IT leadership roles is in recognizing one thing: “We aren’t the experts anymore,” said Hess, a former NICU nurse. “We need to allow those who are at the bedside to do their jobs. We want them to feel that they’re the decision-maker.” And that means treating nurses, physicians and pharmacists as subject matter experts. “You may know the technology, but have you spent 12 hours at the bedside or at a clinic? It’s important, whether you’re a clinician or a technical person, to create that relationship. Show them that you do care and you do see them as that expert, and involve them in the decision-making process.”
Finally, remember that everyone has the same goal in mind. “Clinicians are passionate about caring for their patients. When something is distracting or preventing them from delivering that care, they get frustrated. As IT professionals, we have to understand that,” said Patty.
[The next offering in our CIO Leadership & Career Development Webinar Series will focus on ‘Smooth Job Transitions.’ Join us Tuesday, May 21 at noon ET as CIOs Julie Bonello, Michael Elley and Aaron Miri share their insights and answer your questions.]