Closing the Clinical IT Chasm


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How IT and Clinicians Can Effectively Communicate for Success

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Closing the Clinical IT Chasm

  1. 1. Closing the Clinical IT Chasm How IT and Clinicians Can Effectively Communicate for Success Live Webinar August 4, 2009 Sponsored by QWEST Media Partner
  2. 2. About me  Board-certified emergency physician since 1993; actively practicing  MIT background—EE/Computer Science; worked in AI software development  Consultant to multiple healthcare organizations, vendors, practices, and investment groups on matters related to clinical IT  Hospital Medical Director for Information Systems since 1999
  3. 3. This presentation  My observations and impressions on what works, and what does not  My biases:  Non-academic settings  Private hospitals/practice orientation  Not a CMIO  Some sweeping generalizations, and some specifics  I am a ―Communicationalist‖ and a ―Practicalist‖  Spend my time where the rubber hits the road
  4. 4. What I’ve learned  Clinicians and IT organizations speak different languages, and have different cultures  Do your best to get the big things right  Harder to fix things after damage done, credibility lost  Unsuccessful projects go wrong for predictable reasons:  Everyone wasn‘t ―on board‖  Different constituents had different goals/expectations  Desired ends didn‘t match the provided means – product, human or hardware
  5. 5. Is it a technology problem or a communication problem?  People think it‘s about wires and code, but it‘s about people and business problems:  What problem are we trying to solve?  Are we all solving the same problem?  Do we all agree how we‘ll know when the problem is solved?  Good communication—ride out the bumps  Bad communication—produces more and bigger bumps
  6. 6. What you don’t want “The docs just don’t get it” “IT just doesn’t get it”
  7. 7. Why we work in clinical IT  To support the clinical mission  Get your IT people out there, somehow  Talk to the nurses  Talk to the docs  Go on rounds  Sit at the PACS workstation  Go to a couple of department meetings  Caring for people is a noble mission—Inculcate it in your IT organization
  8. 8. And don’t forget the mission… ―Mrs. Smith, I am sorry to report that your husband passed because we couldn‘t easily access his information. But if it‘s any comfort, his information is secure…‖
  9. 9. Practicing medicine  Often not black and white  Patient issues tend to trump all  Significant multi-tasking  Medical training can be ―anti-business‖ training:  TV role models—break the rules; don‘t believe what others say; find what everyone missed
  10. 10. Practicing medicine  Physicians need to make lots of decisions, often fast, with limited info  Not a 8-5 job  Professionally, short time constant—what do I have to do today?  Time constrained—don‘t have enough  Docs give realistic news, and can take it
  11. 11. Practicing IT  Black and white—things work or they don‘t  Hierarchical  Multi year planning  Project plans  Needs requirements  Can bog down in detail  Meet the requirements—we succeeded
  12. 12. Contrasting worlds The world of IT The world of physicians  Specs must be clear  Specs may be vague  8 to 5 daily schedule;  Varying, unpredictable standing meetings schedule  Multi year project plan  ―3 cases this afternoon‖  Hierarchical, structured  Collaborative, fluid decision- decision-making making  Careful diligence  ―I like that sales guy‖  Organization-driven  Data-driven  Paid for meetings  ―Meetings cost me money!‖
  13. 13. Tough sells  ―It will only take a few extra minutes…‖  ―It‘s for the good of the organization‖  ―Not doing this will hurt patient safety‖  ―It‘s a security standard‖
  14. 14. Easy sells  Save you time  Make you money  Make your life easier  Helps patients (really)  Cool interface  Works well  Compelling data  Respected colleagues advocate
  15. 15. How to sell to clinicians  Use clinical data (that applies to their world)  Use clinical people  Leverage respected clinicians, get them on-board (by solving their problem)  Don‘t get bogged down in tech details
  16. 16. Not all physician advice sources are created equal  Be sure your physician advocates speak for the broader physician target audience  Understand the underlying physician dynamics and politics  The best physician advocate— experienced, established, medical staff leadership track record, not a hot-head  Engage the Med Exec Committee
  17. 17. Engaging physicians—the big picture  Build clinical relationships  Gather informally  Choose your battles; give and take  Radical idea—treat the docs like adults!  Make sure they understand your landscape  Be careful of strident messages from potential outliers
  18. 18. Engaging clinicians—nuts and bolts  On their schedule—often early a.m.  Feed ‗em  Clear process/meeting goals, end dates  Be proactive, not reactive  ? Pay docs for key participation  Support your statements with data
  19. 19. Running a meeting with physicians  Start and end on time—even if they don‘t  ? set ground rules at the outset— sometimes  Know who your allies are; prep them a bit  Use docs to manage difficult docs  When there are challenges, let them vent;  Know when things are simmering—don‘t let it boil over!
  20. 20. Getting a message to physicians  Machine-gun approach  Med staff office  Where they eat  Where they work in hospital  Department meetings  Their office managers  Unit directors or coordinators  Simple; to the point; one page
  21. 21. Other potential pratfalls  Good projects can go bad for a variety of reasons  A bad implementation can kill a good system  A good implementation can make a fair system succeed  Don‘t implement a ―bad‖ system
  22. 22. Avoid blocking/tackling missteps  Can‘t have too many workstations  Can‘t fully predict the optimal form factors  Can‘t have too fast response time  Can‘t have too reliable a network—wired or wireless  Can‘t have too easy system access
  23. 23. Who owns the project? Hopefully not IT  Things can go wrong when IT ―owns‖ a clinical project—careful IT leader, you could be getting set up  Things go better when the clinicians ―own‖ the project—nurses, doctors, or a combo  Yet IT needs to manage the project – clinicians can‘t  Best—trusted clinical/IT relationships; Clinician leaders own; IT steers
  24. 24. Doing due diligence  Have to do site visits  Take clinicians on the site visits  Need their perspective  Bonding  Wander off on your own—away from the official guide  The CMO, CNO, CIO have important perspectives, but not the full perspective  Talk to multi end users  Talk to the ward clerks, secretaries—they know
  25. 25. Deployments  Think of deployment as a multi-week/ multi- month process—not a three-day process  Important to circle back two, four and eight weeks later  Best training is live training, at or right before go-live  Best trainers are/were clinical (often nurses)—make sure there are enough
  26. 26. How to kill a good initiative  Solution doesn‘t deliver ―the goods‖  Runs slowly or poorly  Training disconnected from implementation  Difficult log-ins  Clinicians don‘t know how/where to get help  Clinicians don‘t know who to turn to—who to communicate with
  27. 27. Summary  Effective communication will:  Help you make the right decisions at the outset  Help you manage expectations  Help you work through the inevitable hiccups  Win advocates  Help you get it right  Make for a happier career and IT org
  28. 28. Get in touch Mark Radlauer, MD
  29. 29. Eric Bozich August 4, 2009 Not to be distributed or reproduced by anyone other than Qwest entities. Copyright © 2009 Qwest. All Rights Reserved. CP090960 8/09
  30. 30. What Qwest has Learned in Working with Healthcare Providers • Understand approach to serving patients first • Work with stakeholders to develop solutions that • Improve cost efficiencies of providing care • Improve productivity of staff • Result in improved patient outcomes & experiences Not to be distributed or reproduced by anyone other than Qwest entities. Copyright © 2009 Qwest. All Rights Reserved.
  31. 31. Really… • Improve Ability for Clinicians to work together • Real Time Images • Scan Images at the click of a mouse • Collaborate • Video • Telemedicine • Improve Ability for Staff to address increasing demands of patients • Call routing • Appointment reminders • Voice mail to e-mail • Fax to e-mail Not to be distributed or reproduced by anyone other than Qwest entities. Copyright © 2009 Qwest. All Rights Reserved.
  32. 32. How We Help IT Staff • Help lessen the daily fires to allow for longer range planning • Improve performance and access to applications running on the network • Simplify Network Administration • Consolidate communication services & vendors • Reduced trouble tickets • Easily add new sites to the network • Centralize support and control while decentralizing access • Security Services • In partnership with IBM • Private Networks • Share our experience from working with many Healthcare customers • Benchmark architectures and communication platforms • Advise issues other providers are seeing, what they purchased to resolve and results they received • Provide dedicated account teams, service support and best in class migration and project management help Not to be distributed or reproduced by anyone other than Qwest entities. Copyright © 2009 Qwest. All Rights Reserved.
  33. 33. Questions?
  34. 34. To learn more about Qwest Healthcare solutions, visit: Not to be distributed or reproduced by anyone other than Qwest entities. Copyright © 2009 Qwest. All Rights Reserved.
  35. 35. Learn More Webinars from Healthcare Informatics
  36. 36. Contact Information Richard Jarvis Webinar Director Phone: 212.812.1413 E-mail: Abbegayle Hunicke Webinar Project Manager Phone: 212.812.8429 E-mail: