In my last blog post, I talked about some of the challenges of meaningful use, and about how many healthcare providers view it as less than meaningful. It’s hard for clinicians to embrace this initiative when they view the change that comes with it as making their jobs harder, and they can’t readily see the benefits of it.
So where do we go from here? How do we find the meaning in meaningful use?
In my role as director of healthcare information for Dimensional Insight, I work with hospitals on issues such as this one, using my experience in the areas of nursing, finance and operations to bridge the gap between the clinical side of the house and the IT side of the house. I believe a lot of good things will come from meaningful use – but that providers must implement technology in the right way to see these benefits. How can they do that?
Clinicians must understand why changes are being made.
No one likes to be told how to do their job, and when clinicians are simply told to change their workflow without being told why they must change it, they will rebel. I know of very few people who like change just for change’s sake. But if there’s a reason to change? Something real that people can get behind? That’s when we’ll see progress.
One common complaint is that physicians and nurses don’t currently document enough information in the EHR. Now, it’s not that these clinicians aren’t going through a problem list – they are. That’s their job. It’s just that they’re doing it in their heads as they’ve always done. When I was working in the ER, if you told me that I had to write down everything at the time I was doing it, I would have thought you were crazy. With a line of patients out the door who needed to be seen urgently – I didn’t have that kind of time.
So if we are going to change that workflow, it needs to be clear as to why we are changing it. For example, under the traditional workflow, it might take doctors more than 30 days to input information into the EHR. Under a new workflow with data that is immediately entered into the system, physicians will be able to see outcomes and improve their practices based on that. Take one of our customers, Main Line Health. By analyzing clinical data, the hospital system was able to improve care to its diabetes patients by showing that one treatment was more effective than another. One of the keys to its success, though, was that it communicated to physicians why it was changing the workflow and what results it hoped to get from that. (You can read more about that case study here.)
As a warning, though: Don’t completely overhaul the way doctors and nurses work. Even if you have the best intentions, clinicians do things the way they do them for a reason. That brings me to my second point…
IT needs to understand clinician workflow.
The goal of technology is not to add layers upon layers of extra steps into the system or to completely revamp a workflow. It is to provide additional value to what is already going on. That is why IT needs to understand how doctors and nurses work, and try to complement that workflow with technology. As one of my former COOs once said, “The IT solution needs to enable the work, not be the work.”
This area is where I focus a lot of my work with customers. I sit down with all the stakeholders in an organization – finance, operations, IT, clinicians – and get them to see each other’s points of view and understand where the other side is coming from. I view this as a critical step – and unfortunately, it’s a step that not enough organizations are taking. But really, to see improvements from technology, people within an organization – no matter what their role – must share information and be on the same page about the goals and anticipated outcomes of technology. Once this happens, we will truly start to see change and find the meaning in meaningful use.
The next step for meaningful use will be Stage 3 in 2017. That’s when healthcare providers will have to prove the value they are getting from their EHRs. I think Stage 3 will be really exciting, as it’s when all the different pieces come together. What can organizations expect when that happens? I’ll talk about that in the final blog post of this series. Stay tuned.
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