There isn’t a healthcare CIO out there who doesn’t care about user experience, and doesn’t want to improve it. But the myriad hurdles that exist — including time and cost demands — can make it extremely difficult to devote resources toward enhancing usability.
And the cycle continues, leaving all parties frustrated.
There is, however, a way to end the cycle, according to Taylor Davis, VP of Innovation with KLAS Research, and Christopher Longhurst, MD, CIO at UC San Diego Health, who will present during the “Leadership from the Edge” program at the upcoming CHIME19 Fall Forum. And it doesn’t involve pouring money into new tools; but rather, “getting feedback from clinicians and taking a data-driven approach to improve the end user experience.”
It may sound simple, but it involves asking some difficult questions, and potentially facing some harsh truths. Davis and Longhurst, who session is entitled, “CIOs Win Playing Offense, Lose Playing Defense,” are referring to the Arch Collaborative, an initiative that leverages surveys and benchmarking to identify pain points in EHR use and identify best practices.
Through its research of more than 200 organizations and 70,000 physicians, KLAS uncovered some interesting findings, said Davis. “We see some differences in the mindsets of CIOs that have created successful environments for their clinicians, and those who have not. And a lot of the difference comes down to this question: do you play offense or defense? A defensive CIO might say, ‘we’ve stood up systems, they’re stable, and people can use them the way they want.’” An offensive CIO, on the other hand, will take it a step further by setting clear expectations, ensuring a solid infrastructure is in place, and incorporating feedback as quickly as possible to drive better outcomes. “It’s about driving proficiency, iterating quickly, and emphasizing workflow efficiency,” he added.
Before organizations can establish goals, however, leaders need to understand the scope of the problem, which is nearly impossible with only anecdotal evidence. That’s where the Arch Collaborative comes in, according to Longhurst. “They’ve created a large data set that allows organizations to benchmark. And that’s a key tenet of quality improvement; if you want to improve, you have to understand where you’re coming from. If you don’t measure it, you can’t improve it.”
For Longhurst, a board-certified pediatrician and clinical informaticist, one insight in particular from KLAS’ research resonated quite a bit. “The greatest single variable contributing to EHR user satisfaction is the quality of their initial training,” he noted. “Having been through several go-lives, I can attest that it’s really important.”
When he was with Stanford Children’s Health, the organization recruited eight medical students to train physicians, which resulted in extremely high satisfaction scores. On the other hand, outsourcing training to consultants with little knowledge of the culture — which some organizations do — can result in users who are frustrated, and lack a deep understanding of the system. And that, he noted, can lead to ongoing user satisfaction issues.
So how can CIOs and other leaders move the needle? “It’s not about getting more resources to configure the system; it’s about having a team of physician informaticists who can offer local support. It’s having a program in place to go through every clinic and spend a few weeks identifying best practices, redesigning workflows, and ensuring you’re supporting team-based care where everyone is operating at the top of their license,” Longhurst said.
And while it is certainly advantageous having clinical experience under your belt, CIOs don’t have to be an MD to be effective. A great example is one of his own mentors, Ed Kopetsky, who was “phenomenal at listening to feedback.” For CIOs without a medical background, Longhurst strongly recommends partnering closely with clinical leaders, including the CMO, VP of Medical Affairs, and others “who have their ear to the ground.”
Through their presentation, Davis and Longhurst seek to increase awareness, both of the challenges that exist and the “data-driven solutions” that can help mitigate them, and dispel the myths that are preventing organizations from realizing their full potential.
“We all got into this field because electronic records can help support the delivery of more reliable, higher quality care,” said Longhurst. “We have an opportunity to do that. To me, that’s exciting.”