Physicians seeking to coax their colleagues into adopting electronic medical-record systems should work to convert the skeptics in their organizations while keeping early adopters at arm's length, according to speakers at a McKesson Provider Technologies-sponsored EMR seminar held Oct. 12 in Chicago.
The event was the last in a series of seminars held this month in Atlanta, San Francisco and New York in which regional healthcare leaders exchanged ideas and debated issues surrounding the sometimes bumpy road from paper to electronic records.
Todd Rowland, M.D., director of medical informatics at Bloomington (Ind.) Hospital, said that it is possible to create "an army of medical (information technology) champions" by winning over IT skeptics who will then, by example, convince others that electronic systems have value.
With this strategy, Rowland said, some of the most technology-phobic physicians at his hospital now vow that they will never return to paper records. "I almost fall over when they say these things," he said.
Eric Liederman, M.D., medical director for clinical information systems at the University of California Davis Health System, Sacramento, referenced the classic Life cereal commercial when he told attendees that they need to get "Mikey" -- the person others believe will never adopt IT -- to join the cause.
Liederman, however, went one step further and advised the audience that they also need to "be willing to lose" early IT adopters as allies in their efforts.
"Early adopters will lead you astray," he said. "They will tell you to do things that nobody else wants to do."
Liederman also stressed how simple aspects of the computerized physician office, such as communicating with patients via e-mail, can have multiple side benefits.
The fear that high-need patients will flood a doctor's office with e-mail messages has turned out to be unfounded, Liederman said. He cited studies that show how e-mails eliminate multiple rounds of phone tag, free up time that can be spent with family or seeing more patients, and provide legible and accurate documentation of physician-patient discussions.
"Phone calls create phone calls," Liederman said, adding that it takes less time to read e-mails from long-winded patients than it does to listen to them talk on the telephone.
Rowland said that it pays for physicians to let their community know they are using EMRs because it will help them build a reputation for achieving better outcomes and dropping fewer balls.
To recruit doctors into a community EMR collaborative, Rowland acknowledged that independent physicians in private practices can be "some of the most difficult users to satisfy," but he said they have to be viewed as small businesses that want to remain autonomous.
Rowland said independent physicians have limited resources to finance and research long-term investments in IT, so they need to be shown where they can go for quick and helpful information. He added that drafting a community IT plan will help them ask the right questions while "putting vendors on notice" that area physicians already know what they're looking for.
"There needs to be a modular approach, a series of steps that leads to Mount Everest," Rowland said, adding that, while it was important to start slow, because of the documentation requirements of emerging pay-for-performance programs, it was equally important just to get started.
"Everyone should prepare for this," Rowland said. He added that physicians who think they can turn a switch and have their electronic medical records ready to go when a pay-for-performance program is imposed on them are mistaken. They risk falling behind, Rowland said, because it takes months to years for physicians to adapt to the new way of running a computerized practice.
Steve Bence, McKesson's director of ambulatory solutions, said physicians have been falsely characterized as resistant to technology.
"Physicians want to adopt technology, not just for clinical applications but for business as well," he said. "Physicians just want some help -- they're not Luddites."