If you surveyed a large number of hospital IT leaders, I’d wager that most would claim that they take their clinicians’ EMR preferences seriously. After all, it doesn’t do a hospital a lot of good to install a system that throws doctors and nurses a productivity-lowering curve ball.
There’s lots of ways hospitals can involve doctors and nurses in the EMR selection and go-live process, but I think we can agree that it’s important to involve them somehow throughout. The thing is, a preliminary or perfunctory effort isn’t likely to have much effect. Getting doctors on board, then losing interest in their needs in a year or two, seems a bit counterproductive, doesn’t it?
Well, if one of our readers (a physician) is any indication, hospitals are developing a terrible track record for keeping clinicians in the loop over time, even if they started out gung-ho. Listen to the story told by one of our EMR and HIPAA commentors:
I made a major effort over a period of years (since we went live in February 2001) to be involved [with our EMR rollout]. I was the Chair of a local users group until the group disbanded in frustration at being ignored. I was on the EHR and IT Steering Committees. I devoted countless (unpaid) hours to behind the scenes work, managing custom lists, writing letters, designing and fixing templates. I went to the annual national user’s meetings (on my own dime) to collect ideas and learn more. I took programming courses to improve my ability to contribute.
At the beginning, I (and a core of others) were recruited, appreciated and heavily involved in decision making. As time went on, however, our involvement was marginalized to issues of how to deploy the decisions made by those who used the data. Those who actually use the EHR to care for patients are less and less involved.
As if that wasn’t frustrating enough, the institution didn’t offer clinicians any meaningful input when it came to choose an outpatient EMR:
A small group (including a minority of clinicians) worked in private to narrow the candidate EHRs to two, which were presented to the medical staff for ‘feedback’ with brief non-hands-on demos and no actual system for clinicians to provide concrete feedback. The existence of the project was not made known to the users until time for picking a new EHR from two options, and at no time were the users contacted to find out what worked well or poorly in the current system, and what should be sought in a new system.
In my discussions with providers at other institutions, I get the impression that this is a fairly common approach.
I may be a journalist, not a CIO, but it seems pretty obvious to me that giving doctors meaningful input into which tools they’ll be using is a no-brainer. How about you readers? Do the doctors at your facility feel ignored when you make health IT decisions that will affect them?