The following is a guest article by Troy Foster, Senior Manager of Communications Infrastructure.
Over the years, I’ve participated in a number of clinical technology rollouts. As I’ve taken part in clinical workshops, discovery sessions, and training and go-live activities, providers are often conspicuously absent. At the same time, as I’ve talked to many clinical leaders, nurses and support staff, they all have unanimously expressed a strong desire that the providers are included in the technology offerings.
When I’ve inquired as to the reasons providers are not more involved, the reasons range from, “Well, they don’t work for our organization directly so we have limited ability to require participation,” to “The providers don’t have time”. Over the last few years, I’ve been involved in a few rollouts where providers were included and the adoption rate of the technology was quite good. As I’ve gone back over those particular projects, a few key elements seem to stand out.
Identify ways the technology can benefit them – A few years ago, I was responsible for rolling out a Real Time Locating System (RTLS) solution across a large oncology MOB. RTLS was a new technology that was included in the technology offerings and the staff expressed a strong desire to have the providers wear the badges so that they could more easily locate them.
Providers were initially quite reluctant to agree to participate in wearing the RTLS badges. Rather than try and force compliance, the project manager called a meeting with one of the lead physicians at the facility and conducted a RTLS technology overview. As the meeting progressed, the group started exploring challenges or obstacles the provider teams have that could maybe be simultaneously addressed. The provider team expressed a frustration that the team has with patient consults. Being an oncology outpatient center, the consults were often very difficult and emotional engagements between the patient and the provider. As a result, often the providers would find themselves somewhat “trapped” in a room and unable to disengage to go meet with other patients.
We quickly realized that we could help and by discreetly pressing a button on the RTLS badge while the provider was being located in a consult room, the physician was able to trigger an alert to the nurses that he was ready to transition to another patient. The nurse would then poke their head into the consult room to see if there was anything they could do and the provider would transition themselves out. This change created a win/win scenario for both nurses and providers. The providers were able to significantly increase the number of consults they can do in a day and the nurses were ecstatic they could now locate the providers.
Leadership – Every industry is like a tight fraternity of like-minded individuals whether it be nursing, teaching, construction, IT, etc. Providers are no different. As an IT professional working in healthcare, I learned early on that if I was going to expect nurses to listen and engage, I need to make sure I included peers of theirs in the presentation and delivery. Providers are no different. Identify key provider stakeholders in your organizations that can act as champions for your cause. Target key executives like your CMIO or other clinical executive roles that are staffed with trained providers to assure their participation and engagement in the project early on.
I worked with a CMIO who did an outstanding job of helping our team identify key champions across the various specialties, regularly attended project planning sessions and personally attended several provider training meetings in order to help drive up adoption and participation. These are the same individuals that continue to promote the technologies once live and they can also relay feedback from their peers.
Training and Follow-Up – Providers are no different than any other technology user in the organization. They need to be trained and they want to be involved in decisions that affect their workflows. Training can be much more of a challenge for providers. They often work much more independently and they often rotate across a number of different facilities. This means that they are sometimes expected to learn to use technologies that they only interact with once a week!
At our university hospital, we set up a booth for incoming resident students to introduce them to our technology, provide basic knowledge and answer any questions. Our enterprise secure messaging solution requires most of the providers to use their own personal devices. During the onboarding, we offered the providers a small, free portable battery and charging cable as a token of thanks. We also installed charging cables in every team room so they could more easily and conveniently charge their personal devices. Based on feedback from follow up rounding and discussions, we installed small cabinets in ingress/egress hallways for providers to more easily check RTLS badges in and out as they arrive and exit. Although creativity is often needed, a commitment to insuring follow-ups and training occurs is a key contributor to long term technology adoption.
According to Medscape‘s 2019 National Physicians Burnout & Depression Report, roughly 40%-50% of providers are burned out. Combine that with a population that has a growing number of baby boomers needing healthcare, the prognosis for the ability to maintain and enhance the standards of healthcare seem to be in jeopardy. Utilized and supported properly, technology has proven that it can dramatically improve the provider’s day to day work by simplifying and even eliminating menial tasks and allowing them to engage directly with more patients. New advances in telehealth, speech recognition, communications and treatment are helping to reduce burnout and enhance productivity. However, the journey needs to include representation and involvement of the provider network in order to enhance the adoption and satisfaction of the technology rollouts.
About Troy Foster
Troy has been working in healthcare for almost 25 years. He has worked as a consultant, vendor and internally within hospital IT. Troy has spent the past 5 years as the senior manager of communications infrastructure at Stanford Hospital. Troy’s background includes extensive experience in nursecall, secure messaging and alert/alarm middleware as well as several other communication and clinical IT systems and he has presented at numerous conferences across the country. Currently, Troy is heavily involved in the activation of a new 850,000 sq foot hospital.