Tips from a clinician and healthcare IT expert. Why clinicians play such a vital role on an EMR implementation project team, what they need to be most effective, and finding the right clinicians to fill the role.
You have procured and purchased a new and very promising software - one that is expected to deliver efficiencies, elevate the way your employees perform their work, and with it bring about potential disruption to their work processes. There are several considerations to ensure the success of the upcoming implementation. Without careful consideration, the vision and strategy can completely derail.
The project team
One of these vital considerations is the project team
- Who will be in this team?
- What representation is required?
- What characteristics and experiences will they bring?
- How can they contribute?
The most significant users of your new software will be clinicians. It makes sense to have them represented within the internal project team. Clinical systems are hardly one size fits all, so there is bound to be a certain level of customisation to ensure the software fits within your organisation. Who better to assist with the requirements gathering, workflow analysis, communicate concerns, and work closely with the vendor than clinical end-users? Healthcare is increasingly complex, the engagement for clinicians in the redesign of care is critical, but it comes with challenges. To harness their zeal and passion for the continuous improvement of patient care and in line with your digital transformation strategy, they need to understand the connection between the new system and the care for their patients. This is where you can use your clinical end-user champions.
What do they bring to the table?
Clinical end-user champions. What do they bring to the table? Below are just a few of their crucial contributions.
- Tenacious advocates and drivers of reform and change.
They are passionate about their workflow! Significant changes to it would require a consensus and a lot of deliberation. This long deliberation can push the project out as there would be multiple ideas, disagreements and it would need a leader to ensure a decision is made on time and agreed upon by the majority.
There will be push back. Clinicians are very good at finding flaws; they are very good at diagnosing problems after all. Listening to dissenters may benefit the project as they may have the right outlook to prevent problems. There will always be those opposed to the change and it will take a bit of time convincing them, but the aim is to win most, if not all of them over in the end. Because these champions understand the vision and strategy of the organisation, they can persuade others of the importance of the initiative and its worth. Especially when these initiatives affect patient/clinician interaction and clinician/clinician relationships.
The ability to engage clinicians who are initially sceptical is crucial for success. They appreciate an honest appraisal of what to expect from the system and it will be better received and garner more support as a result.
- Innovators and motivators.
They are the clinical subject matter experts who will assist in customising the new system to meet workflow and documentation requirements for their clinical areas and others.
They ensure that end-user insight and ideas about how the product and the organisations services and work processes can be improved, are harnessed, listened to, and acted on. It is important to have clinical end-users involved, that they have a contribution, that their opinions are sought, their views matter in the design of the system they are meant to use.
They inject positivity, assisting and motivating their peers in adopting and using the system during the implementation. Responding positively to suggestions and feedback from peers leaves them feeling they have a hand in improving the system.
- Assist in planning activities and developing strategies to ensure the system is implemented and adopted effectively.
They can facilitate internal workshops ensuring there is a mix of clinicians within various speciality areas to educate and iron out any issues surrounding design and workflow.
They assist in education strategies, identifying peers who can become super-users or trainers for various speciality scenarios. For software that requires extensive training, they can help create training programs that are effective as they know the unit, the needs of the users within that unit and the flow patterns.
- Build relationships across organisational boundaries.
They are the link between the vendor and the internal organisation. They are tasked to lead and work in partnership with executives and managers.
They can respond to negative challenges from other clinicians to ensure the implementation keeps moving forward. And because part of their role is to promote the new system, it makes the vendor’s job easier when showcasing products and features. When design and implementation issues arise, they can assist with identifying and defining acceptable workarounds, thereby facilitating peer support.
To ensure trust in the implementation process, it is important to be transparent and acknowledge the limitations of the new system. Set realistic expectations of potential problems and roadblocks.
For your champion to be most effective, they need
- Time-release from their day jobs
- Reinforced job security, flexible working, secondment opportunities
- Reduce their stress of worrying about their client-facing work on top of the implementation project they are involved in and foster peer support
- Remove barriers such as shortage of time, perceived lack of project knowledge or competency by providing administrative support, peer support, mentoring, training and better communication
- Support from the executives and direct managers
- Ensure effective two-way communication, especially upward communication. This builds trust, but also results in better strategy, policy, and performance
- Invest in clinical leadership development
- Incentives (What is in it for me?)
- Offer reimbursements, overtime fees, administrative help
- Apart from monetary incentives, extrinsic motivations like opportunities for research publications, career advancement and professional development
- Better solution design and streamlined workflow, with room for optimisation
- Increased clinical engagement and contribution, reducing resistance to the implementation and increase user adoption
- Improvement of practices and quality of patient care (patient outcome measures)
- A more positive relationship between vendors and end-users
How to find your clinical champions
There needs to be a plan to allow for review of potential candidates, that would tease out those clinicians that may have direct involvement in the areas to be affected by the initiative. There are some eager clinicians out there that would happily raise their hands when they learn of the transformation about to take place. I know of one physician I had the pleasure of working with on a project, who, as part of the client project team, was excited to help drive the transformation and ensure the implementation succeeds. He definitely made my life easier in terms of selling my ideas and recommendations to a room full of physicians.
It is worth having a face-to-face conversation with potential candidates to describe the initiative, what the expectations are as to the outcome for patients and the daily work of clinicians, as well as their possible role within the project. Body language says a lot about how keen they are. It would help if you then attracted your choice of clinician with both intrinsic and extrinsic incentives.
If you are new to digital transformation, or if you have been a part of one and experienced implementation challenges, most especially around clinical adoption, you would understand why including a clinician in your team deserves careful consideration.
There is an oddly satisfying feeling being in a room full of clinicians (appreciating time away from client-facing duties), especially when you are about to showcase the clinical system they will be using soon. I look at it as one of many wins to have them involved, to witness a great amount of interest, is a positive reflection on the commitment of the organisation.
A clinical representative, to champion the vision, is a key member of the project team. Their contribution to the project implementation is invaluable. I have been fortunate to have worked with several clinicians on multiple projects. They bring with them experience, the drive and passion for improving patient outcomes, ideas, insight and of course, credibility. Clinicians will more likely listen to another clinician.
These clinical end-user champions will be your promoter, your advocate for change, your bridge to ensure successful working relationship across the board. They are the greatest advocate, helping drive faster approval and decision making. Ultimately, the new system you purchased will be widely accepted and utilised by your clinicians and in turn, ensure your digital transformation strategy stays on the right track.
Michelle Sayseng Cruz
Clinical Business Analyst, Healthcare IT Expert & Former Nurse
Michelle graduated from the University of Sydney with a Bachelor of Nursing and went on to specialise in Paediatrics. She practiced as a registered nurse in Australia for several years while also attaining a master’s degree in Information Technology. Michelle has extensive Healthcare IT experience having worked with Fujitsu Australia, TrakHealth (InterSystems), Cerner and Orion Health, her roles included Clinical Consultant, Solution Architect and Product Manager. Michelle frequently contributed as a clinical subject matter expert and was a core figure in a number of successful EMR implementations.
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