In executive conference rooms around the country, a common dialogue is emerging. In the wake of multi-million-dollar investments in electronic health record (EHR) systems, healthcare leaders are admitting that they underestimate the “care and feeding” of adopting these new applications. Whether this realization occurs from implementing a new system for the first time, or replacing an existing legacy application, the challenges are largely the same. Change fatigue, resource shortages, user resistance, workarounds, patient safety concerns – all reflect barriers healthcare leaders face adopting new healthcare technology.
But there is good news for healthcare leaders. This month marks the release of the new edition of Beyond Implementation: A Prescription for the Adoption of Healthcare Technology. The book offers healthcare leaders a playbook for approaching and leading the effort to adopt clinical information systems.The book explores several important leadership strategies that have proven invaluable to healthcare executives around the country.
Strategy #1: Establish a New Leadership AgendaLeadership is the most fundamental driver of EHR adoption. Because of its importance to the success of the initiative, leaders must relentlessly commit to making EHR adoption a daily priority for executive teams. This includes focusing on the factors that drive optimal use of clinical information systems long after the implementation.
Time is a scarce and vital asset for every executive team, which faces a host of competing priorities and time-sensitive initiatives. The most successful leadership teams prioritize the right projects that add the most value to the organization. One strategy is to develop a Stop Doing List, a concept popularized by renowned author Jim Collins. The Stop Doing List is the process of choosing which initiatives to stop in order to focus on the most crucial activities. For healthcare leaders, this means eliminating or reprioritizing enough projects to make EHR adoption among the top three priorities for the organization. To develop a Stop Doing List, Beyond Implementation recommends prioritizing initiatives per these criteria:
Strategy #2: Stop Doing List
- Projects/meetings that do not directly affect quality of care or safety
- Projects/meetings that are not related to compliance or legal risk
- Projects that can be delayed with little overall impact
- Meetings that can be eliminated or consolidated
Strategy #3: Engage Clinical LeadershipProviders carry a powerful voice in a healthcare setting. Leaders must actively engage providers and promote their buy-in through several strategies. One strategy includes developing a provider council. Including representation from across the organization, endorsement from top leadership, and a formal charter and vision for the body, this council should oversee and govern EHR use. Another strategy is to engage members of the council to serve as champions of the effort by helping their departmental colleagues and serving as an extension of leadership.
Strategy #4: Create a Tone at the TopCrucial to engaging users in the effort is establishing a tone that emphasizes EHR adoption. Leadership must promote awareness of the initiative by creating a value proposition and brand that connects the EHR system with the organizational vision and mission. Leadership must also establish a rhythm with their messaging and ensure it remains authentic when interacting with users. Leadership should make it a focus to answer key questions about the transition, such as how EHR adoption improves clinical and financial outcomes and how the change will affect users individually. Establishing the importance of the effort, as well as being open and transparent, helps users navigate and accept the transition more easily.
Governance is also another key ingredient of effective leadership. Competing interests, differing opinions, and varying experiences all pose barriers to EHR adoption. Leadership must develop a well-defined governance process, which overcomes these barriers by creating policies and procedures that hold users accountable and define expectations and best practices around use of the system. The governance process should evolve over time to address the evolving needs of users as they adopt the application. After developing the governance process, leadership must measure its effectiveness to enforce accountability and make continuous improvements.
Strategy #5: Governance
To improve outcomes, leadership must track the clinical and financial results of EHR adoption. Leadership should identify, select, and empower the right individuals to lead this effort. These individuals should collect, analyze, and report performance metrics that are important to caregivers and will motivate engagement and improvement.
Strategy #6: Track Performance Metrics to Drive Continuous Improvements
To see improved clinical and financial outcomes, healthcare leaders must ignite and sustain the movement toward the adoption of clinical information systems. It starts with establishing a new leadership agenda that places adoption at the forefront of organizational priorities and continues through strategies that facilitate engagement, communication, governance, and measurement. When leaders engage in these activities, adoption becomes a pervasive mindset across the organization for optimal results.