by Donald Burt, MD
Many hospital CIOs face an uphill battle winning the hearts, minds and fingers of physicians. It’s not because doctors are technology phobic. Quite the opposite: physicians are some of the most ravenous consumers of new information technology. Smartphones and tablets are becoming as ubiquitous as stethoscopes at many hospitals.
The truth is doctors are happy to make screen touches, mouse clicks and keyboard strokes if the application is right. But all too often it’s not – at least not for them; and that gets to the heart of the issue.
The software that CIOs often try to “sell” doctors on using typically wasn’t designed with physician users in mind. Some of these applications end up taking more of the physician’s time than the good old paper way of doing things. And the CIO, who is not an MD, can’t fully appreciate how cumbersome, distracting and unproductive a traditional hospital information system (HIS) can be for a physician. Indeed, physicians love a CIO who enables them to focus on their patients, not technology.
The hard truth is computerized systems that don’t fit into the physician’s workflow don’t stand a chance of being readily adopted by physicians – and that includes systems like CPOE, which are part of the ARRA-HITECH “meaningful use” requirements. Reluctant or grudging physician adoption is therefore a big problem not only for CIOs, but for the entire executive leadership team at hospitals, because now it impacts regulatory compliance and revenue.
The title of a recent study by the Economist Intelligence Unit (sponsored by NEC) accurately sums up the current situation in hospital IT: “Under pressure: The changing role of the healthcare CIO”. The study, based on a survey of 100 senior IT executives at U.S. healthcare providers, reports several top-line findings that struck me as spot-on:
“CIOs also need to secure the buy-in of clinical staff when planning and rolling out new IT.”
“Changing the behavior of those who use the technology — doctors, nurses and other staff — may be a greater challenge than managing board-level expectations.”
Bingo! And that is precisely why CIOs increasingly are not being left to operate alone. A growing number of institutions are “teaming” the CIO with a Chief Medical Information Officer (CMIO), an MD who offers exactly what the CIO needs: a physician deeply enmeshed in the hospital’s clinical systems who can be a credible and effective liaison and technology advocate with physicians. The CIO never studied medicine, and the CMO never studied IT, so employing a CMIO gets hospitals a blend of complementary skills, and an invaluable partner for the CIO. As a team, they are sitting at the “big table,” making strategic, $20+ million purchase decisions for their hospitals related to IT projects that will extend out over four years or more.
Many hospitals have come a long way in a few short years. No longer is the CIO merely a tool of the CFO, trying to force physicians to use a multi-million dollar HIS that the board of directors was persuaded to purchase. When I ran a health network in Western Massachusetts, I suggested that the role of the CMIO should be “the defender of physician workflow.” The key for hospitals is to make physicians want to use their HIS systems, rather than be forced to use the systems. Beating affiliated doctors over the head with a stick hasn’t worked – witness the single-digit adoption rates of commercial CPOE systems over the past 40 years – and it isn’t going to work now.
As hospitals look ahead to Stage 2 and Stage 3 “Meaningful Use” requirements, it will become even more essential that doctors willingly use the HIS. CMIOs will play a greater role in ensuring this happens by keeping IT focused on what matters most: providing productivity tools to physicians that streamline their workflow and that deliver more useful and timely clinical information, which can be applied to improve patient outcomes and let doctors focus more of their time on patient care.
Using this kind of physician-centric approach, I predict hospital IT groups won’t have any trouble winning physicians’ hearts, minds and fingers.
Donald Burt is Chief Medical Officer of PatientKeeper Inc.
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