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Edward Marx, CIO, Texas Health Resources
Marx

Engaging clinicians with health information technology


By Edward Marx
Posted: December 3, 2012 - 3:15 pm ET
Tags:

Our organization has an informal climbing team made up of administrators and clinicians who tackle a couple of summits each year. We have lofty aspirations—the ultimate goal is to climb six of the "Seven Summits." Self-funded, the team's previous climbs have included Mount Kilimanjaro, Mount Rainier, Pikes Peak, Mount Massive and Longs Peak.

In preparation for the upcoming snow-and-ice climbs of Denali, Elbrus and Aconcagua, we selected Rainier as a practice run.

On the first day, we learned related skills: how to handle new tools (ice axe and crampons), survive avalanches, and to be mindful of crevasses—visible and invisible. To reach the summit, we'd have to face these dangers; therefore, we took actions to minimize exposure and risk.

What is the cry of every healthcare organization that's looking to climb to new heights?

"Improve quality!" That's a no-brainer. "Enhance patient safety!" Of course. "Bend the cost curve!" How? Our country continues spending billions on healthcare information technology. Between the American Recovery and Reinvestment Act and the Patient Protection and Affordable Care Act, we will spend billions more. So how do we maximize these investments so we can accelerate IT adoption toward its intended peak?

One technique for success is clear, yet not pervasively embraced: engaging clinicians. We talk about it, even appoint a figurehead or two, but do we push far enough? No. Rather, we end up falling into crevasses. These chasms (e.g., clinician buy-in, CPOE adoption, CDS compliance) are mere distractions in some cases, but in others, they're fatal to the mission of the organization. To reach the mountaintop, we need to close the gap between technologists and clinicians.

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How? Below are six techniques your organization can employ now to minimize disruption and maximize IT investment.
  • Clinical IT leadership. At a minimum, have a chief medical information officer and a chief nursing information officer lead your IT initiatives. Though I may "speak with the tongue of angels," without clinical credentials, my clients only hear me as a loud clanging cymbal. When reaching out, aim to do so with a clinician partner.
  • Clinical IT staff. More than 20% of my team members are certified clinicians. If I break it down to applications, it approaches 50%. It's easier to train clinicians to use IT than it is to train technologists to be clinicians. The clinically certified staff helps shift culture and mentor nonclinicians.
  • Clinician engagement team. I consider this our "SEAL" team—a quick-reaction force that's based in our facilities. Their primary focus is engaging clinicians and ensuring they are maximizing IT use. Three-quarters of the members of this team are credentialed clinicians. Their value is beyond measurement. To me, they are a beacon of insight into dangers ahead. To those they serve, they are an illuminating flood lamp.
  • Customer relationship management. Send your leadership team out routinely to work alongside clinicians. I'm not sure how I could lead IT if I didn't regularly immerse myself in the work of clinicians. Effective leadership requires taking time to walk in your clinicians' shoes.
  • Physician leadership in IT. Make sure your IT decisionmaking body is well-represented by physicians and nurses. This must be more than window-dressing—I'm talking active engagement. Your council should be co-chaired by an empowered practicing physician. Double down to ensure the body has other clinicians on board, such as a CMO and CNO. Don't forget ancillaries.
  • Connections. Connections is the concept of having your IT department spend one day per year shadowing a clinician. This is how you link hearts to brains—another key to success. Ask my assistant what she does and she'll say she improves the health of the people in the communities we serve. At the patients' request and with their consent, she attended the delivery of two babies in the last two years while on Connections. She gets it.
Other techniques exist to ensure clinician engagement with IT. Mine are simple but meaningful strategies to help you avoid the crevasses on your journey. When you see something suspicious on the trail ahead, you will know how to cross safely. Embrace these, and I will see your organization on the summit! We'll celebrate and then continue our journey, making good on the promise of healthcare information technology.

Edward Marx

Chief information officer

Texas Health Resources

Arlington, Texas



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