Communication: The Breakfast of (Physician) Champions
Lehigh Valley Health Network (LVHN) has been rolling out an ambulatory EMR across our network-owned practices over the past several years. Most implementations have gone well—with the expected resistance and temporary decrease in productivity. But some have resulted in prolonged negative impact on productivity and very unhappy providers.
Why do some implementations go well, and others flounder? Many factors contribute to a successful implementation, including detailed workflow and process analysis, appropriate pre-load of existing information, provider-centered design of templates and forms, thorough training and stimulation, adequate hardware and conductivity, as well as excellent ongoing support.
Physician leadership also is a critical success factor. CMIOs are involved in EMR deployments in various ways. Some are involved at very granular levels, including template design and workflow analysis. Some are involved at the oversight or governance level, and utilize practice-based physician champions (PCs).
At LVHN, we employ PCs at the practice or division level to lead our EMR roll-out. As a member of the EMR Oversight Committee who works with PCs, I have seen both their supportive and disruptive characteristics that can impact successful outcomes.
The PC needs to bring passion to the role. Also, the PC must be an excellent communicator to translate the needs of the end users, as well as the capabilities and limitations of the EMR system. Thus, it is critical that the organization provide "protected time" out of the clinical schedule for the PC to work with the IT team and to communicate with providers who are interacting with the EMR.
An understanding of the EMR and its available capabilities will allow the PC to communicate realistic expectations to providers. In collaborating with IT staff and providers, the PC may be involved in screen design, but the IT staff should code the screens. On multiple occasions, I have asked for access to the code, but our project directors have wisely reminded me that my role is leadership, not screen designer.
Most importantly, the PC must bring an understanding of how work gets done at the practice level and a vision of the targeted standard work process that needs to be implemented. For this type of project, it is helpful if the PC is clinically active and will be a user of the EMR. We learned that the PC needs to bring an understanding of what works best for everyone, not just what works best for the individual user. If the PC is computer-savvy, he/she may suggest workflow that makes "technical" sense, but not "physician workflow" sense. Examples include creating obscure macros that the average user can not remember, or non-standard screen flow.
EMR implementations should focus on defining the optimal, most efficient work process through utilization of the new technology. This appreciation for the big picture often is a defining characteristic of a successful physician champion.
Why do some implementations go well, and others flounder? Many factors contribute to a successful implementation, including detailed workflow and process analysis, appropriate pre-load of existing information, provider-centered design of templates and forms, thorough training and stimulation, adequate hardware and conductivity, as well as excellent ongoing support.
Physician leadership also is a critical success factor. CMIOs are involved in EMR deployments in various ways. Some are involved at very granular levels, including template design and workflow analysis. Some are involved at the oversight or governance level, and utilize practice-based physician champions (PCs).
At LVHN, we employ PCs at the practice or division level to lead our EMR roll-out. As a member of the EMR Oversight Committee who works with PCs, I have seen both their supportive and disruptive characteristics that can impact successful outcomes.
The PC needs to bring passion to the role. Also, the PC must be an excellent communicator to translate the needs of the end users, as well as the capabilities and limitations of the EMR system. Thus, it is critical that the organization provide "protected time" out of the clinical schedule for the PC to work with the IT team and to communicate with providers who are interacting with the EMR.
An understanding of the EMR and its available capabilities will allow the PC to communicate realistic expectations to providers. In collaborating with IT staff and providers, the PC may be involved in screen design, but the IT staff should code the screens. On multiple occasions, I have asked for access to the code, but our project directors have wisely reminded me that my role is leadership, not screen designer.
Most importantly, the PC must bring an understanding of how work gets done at the practice level and a vision of the targeted standard work process that needs to be implemented. For this type of project, it is helpful if the PC is clinically active and will be a user of the EMR. We learned that the PC needs to bring an understanding of what works best for everyone, not just what works best for the individual user. If the PC is computer-savvy, he/she may suggest workflow that makes "technical" sense, but not "physician workflow" sense. Examples include creating obscure macros that the average user can not remember, or non-standard screen flow.
EMR implementations should focus on defining the optimal, most efficient work process through utilization of the new technology. This appreciation for the big picture often is a defining characteristic of a successful physician champion.