How Do You Empower Your Physicians in the EHR?
What’s in a name?
It’s an age-old question that Shakespeare answered through Juliet.
Admittedly, her answer wasn’t much more than an eloquent version of, “not much” and if I'm honest I can’t say I agree with Juliet.
As the final chapters of that same play show, Juliet and her counterpart aren’t exactly the brightest of bulbs.
In fact, sometimes names can mean quite a bit! John Muir learned this lesson well when they overhauled their governance structure in an effort to empower their clinical staff. I had the opportunity to talk with Dr. Schlossberg, the CMIO at John Muir, about this process.
As John Muir has tackled empowering their physicians to use the EHR, they learned quickly that they needed to make some changes. They knew John Muir would eventually have to work on the age-old divide between clinicians and IT. They started with a name: Physician Informaticist.
In the past, their physician informaticists would have been more rightly called an IT Systems Analyst. Again, what’s in the name? In this case, quite a bit. John Muir realized that if they were going to call a position “physician informaticist” then they needed to have the role match the title.
Their current physician informaticist role feels more like a customer service position, and less like a systems analyst. The new role emphasizes the need for these IT experts to build strong relationships with the clinicians they serve.
In particular, these physician informaticists have been tasked with helping providers on Epic, Dragon and ePrescribing. Because of this in-depth connection, it’s vital for John Muir’s team to built trust.
How to Build Trust
It starts from the top. Dr. Schlossberg emphasized to me how John Muir’s leadership team has supported physician engagement in IT optimization. Dr. Schlossberg and his team enacted many changes, from the restructuring of job roles to instituting a new governance structure.
Starting in early 2016, they instituted provider-supported initiative like single sign-on for secure messaging. Beyond that, they have created “cast study committees” which operate as think-tanks for optimizing their HIT landscape.
These committees include clinician advocates, who are largely self-selected. John Muir found that elevating the passionate voices in their clinical ranks leads to better, more engaged committees, versus a “volun-told” model for staffing these groups.
Another critical piece of building trust comes from communication. John Muir works to let hospitalists know as far out as possible (an average of 4 months out, they said) about systems going down.
The more lead-time they can put into a clinician’s workflow, the better. As they’ve been consistent in communicating and delivering on these timelines, they’ve found clinician trust increase dramatically. In fact, John Muir placed in the 97th percentile for provider engagement.
Dr. Schlossberg made sure I also understood that John Muir’s progress was far from overnight success. “Success begets success and trust builds trust,” he explained.
His advice was to identify and start with small efforts that have a high chance of being successful and understand that you’ll need time to build or regain trust with between clinicians and their IT counterparts.
Ultimately, the path to happy, satisfied and empowered physicians begins with the conscious decision of leadership to listen to the clinician’s voice.
As brave executives seek out, assimilate and act on the feedback of their staff, they can replicate the successes seen by John Muir and others.