EHR adoption is an ongoing process. As a process, it requires healthcare organizations and providers to resolves obstacles in the way of enhancing or refining their EHR systems. No obstacle is perhaps greater than the ability to get physicians on board and up to speed on the new functionalities or services that are a major part of the hospital’s or practice’s journey toward meaningful and sustainable EHR adoption.
One strategy that is proving successful in mitigating physician resistance is by bringing in physician coaches with both the clinical and technological knowledge necessary to guide physicians through the adoption process and get them to buy in.
“That’s probably the most common additional pushback we get to coaching strategy in that physicians in particular feel they need to be taught by physicians,” says Jeff Martin, MD, Physician Executive at Cerner and architect of its Certified Training Program that sends physician coaches out to client organizations in order to streamline their EHR adoption.
“Typically, if physicians have gone to training, they have knowledge that will allow them to engage a good 80 percent of the work and functionality of an EMR,” he explains. “The challenge becomes when they try to use that EMR in an integrated clinical workflow and find discrete areas that are challenged by their knowledge of the functionality. This is where the adoption coaches come into play.”
This combination of the physician coach and at-the-elbow guidance is already having a tangible effect on NCH Healthcare System in Naples, Florida, which used the approach to bolster its adoption of computerized physician order entry (CPOE). “We’ve been on CPOE for a while, but we’re living in this hybrid world,” reveals Helen Thompson, VP and CIO at NCH Healthcare System.
During its first spell of using physician coaches, the organization saw its percentage of CPOE increase by three points. “Three percent doesn’t sound like a lot,” continues Thompson, “but it is when you think about physicians who write somewhere in the neighborhood of 5,000 orders a month depending on how busy their practice is and how complex their patients are.”
As a result of high physician satisfaction with the physician coaches, the organization decided to bring the coaches back in order to reach its self-imposed goal for CPOE and the result is proof of the effectiveness of the approach.
“Bear in mind, our goal for physician order entry was 93 percent with a 5 to 6 percent of orders being telephone and the other 1 to 2 percent being verbal orders,” reveals Thompson. “Today, we had overall across the two hospitals 91.6 percent CPOE.”
The experience at NCH Healthcare System has already led Thompson to make plans to replicate the program onsite all on its own. In fact, the experience has Thompson quite convinced that having this kind of resource at her disposal for previous implementation of EHR systems and services would have dramatically changed her experience with these adoption projects.
“Physician satisfaction with the whole process would have been so much higher because this is difficult,” she continues. “If I had had this kind of skill set, I know how much easier things would’ve gone and how much easier for the physicians that transition from a paper or a hybrid world would be for them.”
According to Thompson, what is being asked of most physicians during EHR adoption is something very much foreign to them, especially for those whose education and trained ingrained certain clinical approaches and practices into their minds.
“Think about moving from paper to electronic,” she says. “Think about it in terms of learning a foreign language. These physician coaches are like having your own personal interpreter right there at your elbow all the time.”
Considering the challenges that healthcare organizations face in moving through the stages of the EHR Incentive Programs and preparing for major changes to the healthcare industry as a result of ICD-10 and accountable care, it makes sense that they have a guide to help them along.
“We have a long ways to go yet. We are on our digital hospital journey. And these coaches will certainly be pivotal in helping us get there and then of course sustaining that performance,” says Thompson. Source
