I’ve been a real fan lately of Dr. Jayne’s in the trenches commentary on the EHR implementations she’s apart of as CMIO. In her latest post she offered some really valuable insight into the integration of a physician group her health system purchased. The physician group wanted a bunch of custom content and Dr. Jayne’s team had convinced them of half of their recommendations and then she offers this insight:
At this point and given their resistance, I can get on board with half. It’s certainly more than none. Through discussion of their actual needs and observing their workflow, we’ve even identified a handful of customizations that we’re going to advocate that our vendor incorporate into the product out of the box. Ultimately, what allowed us to get the agreement we achieved was the idea they will be piloting the changes for a couple of months after the upgrade and then we’ll revisit them.
We added the pilot approach when we sensed they were stuck in analysis paralysis. The reluctance of the identified physician champions to make decisions was palpable. They feared backlash from their colleagues and claimed to be unable to reach consensus.
I had a somewhat similar situation happen to me on my first EHR implementation. The clinic had real fears about the transition to EHR. However, they needed to replace some old bubble scanning sheets which were no longer supported on this really old system. So, instead of going all in with a full EHR implementation, we did a partial EHR implementation as a kind of “pilot” for the clinic.
What resulted from this was really amazing. A week or so into the partial EHR implementation, the providers started asking us why we weren’t using the rest of the EHR features. In fact, some of them started using the other features before we even asked or trained them on it. I still remember walking into the director’s office and saying, “They’re asking me why we aren’t using all of the EHR features.” We quickly corrected that and implemented the full EHR a few weeks later.
You should never underestimate the value of jealousy. If you let a few people play with the shiny new toy, the others will be jealous. Of course, you better make sure that the shiny new toy works as proposed. Plus, don’t get sick with Pilotitis either.
Dr. Jayne also offered this powerful insight which says a lot about her as a leader in her institution:
I’ve been through this enough times to know what kinds of darts their colleagues might start throwing, so I was happy to offer myself as a virtual human shield. If using the larger health system as the scapegoat for required change is what it takes to move them ahead, so be it.
There are a lot of ways to deal with the “darts” of colleagues. Although, the best answer to the problem is having a real leader with a vision and understanding of where you want to take your EHR. Having a great leader at the helm of an EHR implementation has been the key difference between the good and bad EHR implementations I’ve seen.
