It’s one thing to install a new health IT application. The software vendor and healthcare informatics teams busily prepare for the big implementation event. At a precise moment, a switch is flipped, the new software goes live and, if all goes well, it starts running without major catastrophe.
HIT adoption, on the other hand, is the continuous process of actually integrating new software into medical workflows to maximize its full potential. Where implementation is often a one-time, big bang extravaganza, adoption requires long-term planning, engagement, and education.
In a recent presentation at an event sponsored by The Breakaway Group, Bill Rieger, chief information officer of Flagler Hospital in St. Augustine, Florida, shared his strategy for creating a “culture of adoption” — in contrast to the traditional, but narrow focus of “let’s get ready for go live.”
A computer science major with an MBA, Bill and his executive colleagues knew the value of leading this effort. From the start, they realized the need to get the entire hospital staff engaged and on board. They launched a comprehensive, five-point campaign as the cornerstone for building the culture of adoption, which Bill believes is necessary for true Electronic Medical Record (EMR) integration.
Harnessing WHY? Power
Bill and the leadership team predicted there might be resistance to switching health IT applications. After all, the hospital was already using an EMR, so it was natural to expect people to say, “Why do we need to go through the pain of adopting another system? It was tough enough the first time!”
Bill solicited the help of Flagler’s beloved and well-respected chief medical information officer to establish the guiding principles behind the software transition. This was an important move to court favor with hospital physicians, who are vastly more receptive to ideas from fellow doctors than from health IT specialists. The staff needed to know this move was 100 percent patient centric, with four bottom-line goals that closely align with Flagler’s organizational values and mission:
- Improve quality
- Reduce cost
- Foster loyalty
- Enhance service to the community
Assertively addressing why the hospital decided to upgrade to a new health IT application was the first step in reducing resistance and kindling cultural support.
The Engagement Party
Flagler designed and executed a multi-faceted employee engagement program. After communicating the whys and wherefores, they held a project naming contest, open to all staff members. Along with bragging rights, the winner received a nice little cash award.
Next, departments were invited to participate in a project video. Set to music, departmental dancers — decked in nurse hats, lab coats, and dark glasses — rocked out together. Bill shared clips of the final result, providing hilarious comic relief and proving there’s nothing like a camera crew to draw a crowd. Even camera-shy staff members showed up to watch and kibitz. The video shoot actually became an unexpected point of engagement. In between takes, people started talking and asking questions. As the cameras rolled, EMR adoption excitement took root.
Other engagement activities included a project kickoff event, an online project communication portal, a book signing, a Twitter/social media campaign and a mid-course “reboot” exercise to sustain momentum.
Patient-Centered Care Team
To foster comprehensive project involvement, Bill convinced Flagler’s chief marketing officer to create a team of physicians, nurses, clinicians, subject matter experts and super users to guide the software build by analyzing every click in every workflow and hospital process. He intuitively realized that the larger the number of participants who influence and contribute to the design, the better the design and the greater the commitment to the project’s overall success.
Bill hired The Breakaway Group to create role-based training materials to facilitate health IT adoption. This training was custom designed to help users quickly become proficient in the new software. Learners were assigned short, online courses that simulated common daily tasks. The courses were supported with quick reference guides and practicum exams that tested learners’ ability to perform a combination of routine procedures. This instructional approach is relevant, repeatable and enjoyable. It builds confidence and inspires users to experiment and learn more — two key underpinnings to developing a culture of adoption.
The final key to Bill’s culture-of-adoption strategy was accountability to leadership in the form of a strict governance structure. This undertaking required substantial investment in time, money and human resources. Bill felt it was critical to openly communicate to hospital stakeholders all aspects about the project, including progress, expenses, victories, mistakes and setbacks. He was determined to uphold Flagler’s standard of honesty and integrity in managing this huge venture.
Bill credited a lot of his ideas about adoption vs. implementation to the book, “Beyond Implementation: A Prescription for Lasting EMR Adoption,” written by Jeffrey Woodside, M.D., and Heather Haugen, Ph.D. He said this book articulated exactly what he had been feeling, and his copy bears heavy yellow highlights.
Bill understands that the difference between health IT implementation and adoption is the difference between simply using an EMR and actually leveraging that EMR to improve quality, reduce costs, foster loyalty and provide the best possible service to community patients. His formula for building a “culture of adoption” to yield optimal returns on health IT investment and usage is definitely worth considering.
Laura Speek, MBA, is a learning and development specialist at The Breakaway Group, a Xerox Company.