‘Knowing Your Physicians' Is Key To EHR Success

By Ken Congdon, editor in chief, Health IT Outcomes

Health IT Outcomes was a media sponsor of the NG Healthcare Summit in Scottsdale, AZ last week — a distinction that provided me with the opportunity to attend the event in person. This invitation-only conference gathers CIOs, CTOs, IT directors, and other technology leaders from many of the nation's leading hospitals throughout the country to share their IT successes and challenges. This information is disclosed via a series of workshops, panel discussions, scheduled one-on-one appointments, and simple networking. I left the event with a ton of valuable information that I'll use to develop new content for our web site in the weeks to come.

One of my first interactions at the NG Healthcare Summit was with John Santangelo, director of information technology at Cleveland Clinic Florida. We got to talking about the EHR successes his facility has experienced, and the subject of physician influence on EHR adoption and meaningful use inevitably came up. Now, there's a common perception that older physicians are generally set in their ways and opposed to adopting EHR technologies, while younger physicians are technology savvy and champions of EHRs. While this may be a mass generalization, there is some merit to the concept that the way a physician is "mapped" from a personality and experience perspective will go a long way in determining how amenable they'll be to adopting and using an EHR. Santangelo says that effective identification and management of these key "physician types" has been instrumental in the successful EHR environment at Cleveland Clinic Florida.

In total, Santangelo identifies not two, but three physician types:

1. Old-school docs — While not necessarily age-dependent, these physicians are set in their ways. They are happy with their current paper processes and workflows and not agreeable to change. These physicians will most likely oppose an EHR transition and elect not to use the software implemented.

   "A healthcare facility will likely lose some of these doctors in the process of transitioning to an EHR, or be compelled to force them out of practice because of the negative impact they will have on the facility's performance statistics over time," says Santangelo. "The key to minimizing this outcome is to get other physician leaders, at the highest levels of the organization, to buy-in to the EHR initiative and work with these holdouts on a peer-to-peer level."

2. Wildcards — These physicians make up the middle group. They aren't necessarily excited about change, but they aren't opposed to technology adoption either. This group can potentially be a champion for EHR technology or an adversary. The key to winning them over lies in addressing their unique needs with the EHR.

"Workflows are different for each hospital department, and even each physician," says Santangelo. "IT needs to work with each group and doctor to customize the EHR as much as possible to meet their specific workflow requirements. If you put the time and effort into doing this it will pay off in terms of physician satisfaction with the technology."

3. Residents, Fellows, & Students — This group is the most technologically savvy. Technology has been an instrumental tool they used to learn medicine and they expect to use it in their practice of medicine. This group will not only easily adopt EHRs, but they can help you get other physicians in your facility adjust to the technology.

"We implemented a program at Cleveland Clinic Florida where we affixed blue buttons to the residents we recognized as super users of our CPOE system," says Santangelo. "These blue buttons identified an individual as someone another physician could go to for help. This system worked wonders for our CPOE adoption rates."

Santangelo also leverages residents and fellows to help him identify and test-drive new technologies. According to Santangelo, these individuals offer a non-biased assessment of technology and can tell you if a technology can survive the rigors of a healthcare environment.

Have a comment or feedback for Ken on his article? He can be reached directly at ken.congdon@jamesonpublishing.com.