Creating an environment in which leaders from different departments are able to communicate and collaborative effectively has always been a core objective for health systems. But as organizations continue to grapple with the challenges brought on by Covid, it has become vital to survival. Now, more than ever, leaders from clinical, IT, and other areas need to be in lockstep so they can prioritize key goals and develop strategies for achieving them.
“We have to continue to be laser-focused on how we can remove friction,” said Becky Fox, CNIO, Atrium Health, during a recent panel discussion. “That’s what makes the difference to our patients and our communities.”
By cultivating and maintaining solid relationships, leaders are better able to ensure alignment across the system, noted Allison Morin, VP of Nursing Informatics with Halo Health. However, that can be easier said than done, particularly when organizations are dealing with staff shortages, patient surges, and budgetary constraints, among other obstacles. Recently, Fox and Morin addressed this timely topic along with Pele Yu, MD (CMIO, Arkansas Children’s Hospital), providing best practices based on their own experiences.
“The Great Translator”
Although the panelists come from different backgrounds, all three agreed that the most critical aspect of the CMIO and CNIO roles is to act as a bridge.
“The entire care team is complex and intertwined and interconnected. That’s why it is really important to be ‘the great translator’ and to understand the system-wide perspective of how everything works together,” said Fox. “My role is to translate the needs of clinicians to IT, and to explain to clinicians the opportunities that exist by leveraging IT solutions. We’re here to build bridges to bring people together.”
Fox encouraged viewers to think of the CIO, CMIO and CNIO as a triangle (which can change if an organization has, for example, a chief clinical informatics officer) where leaders rely on each other’s expertise, collaborate, and move initiatives forward.
The question, of course, is how to form these relationships. Although no two situations are alike, there are practices that can help organizations move closer to achieve that goal.
- Meet regularly. For Yu, one of the keys to his successful working relationship with Erin Parker, the CIO at Arkansas Children’s, is meeting regularly and maintaining open lines of communication. By speaking often, the two are more easily able to align their objectives.
- Go deeper. “You need to understand and appreciate where each person is coming from, along with the expertise and experience they bring to the table,” said Fox. Because she has discussed her clinical background with her colleagues, “they understand the experiences I’ve had,” and when a problem arises, “they’re open to the solutions because of that collaborative relationship.”
- Show, don’t tell. The most effectively way to communicate the challenges facing clinicians is by inviting CIOs and other leaders on rounds, Fox added. Being able to show them firsthand how a problem with the IV pumps, for example, affects clinicians — and more importantly, the positive impact it will have to fix them — is simply more powerful.
- Involve clinicians. For Halo Health, including clinical leaders in the decision process is paramount to success. “We make sure they’re at the able and that they’re part of the entire project,” Morin said. “That’s where we see the wheels turning and innovation happening.” On the other hand, initiatives that are IT-driven with little clinical involvement tend to suffer in terms of adoption and engagement.
- Find a champion. At Atrium, no project gets started without a clinical informaticist onboard, said Fox. “They’re involved from the get-go. They already understand the challenges and the clinicians. They understand the scope of the project, they understand our goals and what we’re trying to solve, and then they help become the champions.”
Ambassadors for Change
A critical aspect in any initiative — no matter which parties are involved — is change management. Even a minor tweak to an order set can have a downstream impact. Therefore, it’s imperative for leaders to clearly explain the ‘why’ in terms that users will understand, said Yu. “People are really resistant to change unless they see value in it.”
And although it can be helpful for CMIOs to discuss why an upgrade needs to happen, what’s even more effective is relying on clinical informaticists as ‘ambassadors for change,’ according to Fox. “To me, the biggest challenge is making sure you have the right team to help with that change management.” That means individuals who understand informatics extensively, while also having a broad perspective of the system, and possessing the emotional intelligence required to effectively translate.
“If you don’t have the right ambassadors that are boots on the ground, at the facilities, working with clinicians and leaders, it will be even harder to get anything changed,” she said. “To me, it’s about building the right culture with the teams you have, and making sure that you have the right makeup and composite.”
It’s also important for the vendor partner to have a solid change management approach, noted Morin. At Halo Health, that includes standing meetings with the executive steering committee to ensure alignment continues throughout the project. “There are hard decisions that need to be made,” she added. “There are people who aren’t going to be happy with this technology. We want to have top-down, buy-in before we move forward. We care about the outcomes.”
Finally, leaders must accept the fact that no implementation, or project of any kind, is going to go 100 percent as planned; therefore, the ability to be agile is imperative. “The reality is that things change — workflows change, and that’s okay,” said Fox. “The complexity of healthcare isn’t going to go away; it will only continue. And so we have to have the right people in the right place, giving the right advice and guidance, and bringing people together in order to make a bigger impact for all of us.”
To view the archive of this webinar — The CIO’s Best Friends: Leveraging CMIOs & CNIOs to Foster IT Success — please click here.