My career in medical informatics has spanned more than 15 years. During that time, I have witnessed innumerable changes in the processes, technology and people related to health IT solutions.
It used to be that the focus was almost entirely on clinician adoption, even if it adversely impacted outcomes and value. Clinicians and health systems were certain that they and their patients were unique, and process standardization and decreasing variations in care was only the dream of a few.
We certainly have come a long way from those early days. Today, most healthcare leaders are united around the belief in open, interoperable technology, and that standardization within an organization and across the industry is necessary if we are committed to improving the health outcomes of patients.
Throughout this evolution, there are four key factors of health information technology integration that have remained constant. In my experience, these factors are critical to the success and value of an organization’s health (HIT) solutions—unwavering executive support, engaged clinical leadership, transparent communication and a responsive governance structure.
Unwavering support and sponsorship from the healthcare system’s executive leadership is critical. Initial adoption and ongoing optimization of health IT requires changes in organizational culture. Providing executive leadership with regular updates and assuring understanding of the current and future state of health information systems is critical. This will enable them to clearly and consistently articulate that leveraging the health information system is an organizational imperative, not merely an IT project. The commitment of the organization to improve outcomes and decrease harm cannot be overstated.
Someone once told me that the medical staff is the only legal entity in the United States where a vote of 99 to 1 is called a tie. That comment made me laugh, but it’s also a little bit true—change is difficult for everyone, but it is particularly hard for clinicians, for whom adopting new technology and learning a new way of doing something may seem inefficient or would take away time from the work of treating patients.
This is where clinical leadership is critical. Engaged clinical leadership is required to help navigate through the changes in technology and workflow that accompany health information technology integration. Clinical leaders understand the concerns of their colleagues and can help gain acceptance with the various decisions that are made.
Although traditional leadership, such as the Medical Executive Committee, need to be involved, looking for leaders beyond this group will enhance the success. In my experience, engaging leaders with a wide variety of backgrounds in their use of technology adds credibility. It is important to engage health IT specialists, but it is just as important—perhaps more important—to include average users in the leadership circle.
Communication with hospital staff
“I’m not sure if this is true, but I heard...” That phrase is perhaps the most dangerous that exists. It starts wildfire rumors that overtake hospital staff before new technology is even in place.
When communication is poor, it can cause major issues in achieving objectives. It is important to develop a communication plan and follow it. I recommend organizations adopt an official mode of communication (generally, this comes in the form of an email). This creates clear expectations for the transaction of information. This does not preclude the use of other forms of communication, such as in-person meetings, town halls and one-on-ones.
Remember: It is nearly impossible to overcommunicate key information. At the end of the day, effective, consistent communication leads to participation and engagement.
Health IT governance
A sound governance structure is necessary to handle the myriad issues that arise in the normal course of HIT adoption and optimization. Stakeholders need to know how decisions are made so that they develop trus Included in governance is a clearly articulated process for change control. During my tenure as the chief medical information officer at a non-profit community hospital, we had a clearly defined governance processes that was accessible on our intranet so that the entire organization was engaged and aware. This not only set expectations appropriately, it also demonstrated the dynamic nature of HIT and the commitment to continue to optimize. t in the system and their leaders.
This column was originally published on the Cerner web site and can be accessed here.