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How IT and Clinicians Can Effectively Communicate for Success
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Closing the Clinical IT ChasmHow IT and Clinicians Can Effectively Communicate for
Success
Live Webinar
August 4, 2009
Sponsored by QWEST
Media Partner
About me
Board-certified emergency physician since 1993;
actively practicing
MIT background—EE/Computer Science;
worked in AI software development
Consultant to multiple healthcare organizations,
vendors, practices, and investment groups on
matters related to clinical IT
Hospital Medical Director for Information
Systems since 1999
This presentation
My observations and impressions on what works, and what does not
My biases: Non-academic settings
Private hospitals/practice orientation
Not a CMIO
Some sweeping generalizations, and some specifics
I am a ―Communicationalist‖ and a ―Practicalist‖
Spend my time where the rubber hits the road
What I’ve learned
Clinicians and IT organizations speak different languages, and have different cultures
Do your best to get the big things right
Harder to fix things after damage done, credibility lost
Unsuccessful projects go wrong for predictable reasons:
Everyone wasn‘t ―on board‖
Different constituents had different goals/expectations
Desired ends didn‘t match the provided means –product, human or hardware
Is it a technology problem
or a communication problem?
People think it‘s about wires and code, but it‘s about people and business problems:
What problem are we trying to solve?
Are we all solving the same problem?
Do we all agree how we‘ll know when the problem is solved?
Good communication—ride out the bumps
Bad communication—produces more and bigger bumps
What you don’t want
“The docs just don’t get it”
“IT just doesn’t get it”
Why we work in clinical IT
To support the clinical mission
Get your IT people out there, somehow
Talk to the nurses
Talk to the docs
Go on rounds
Sit at the PACS workstation
Go to a couple of department meetings
Caring for people is a noble mission—Inculcate it in your IT organization
And don’t forget the mission…
―Mrs. Smith, I am sorry to report that your
husband passed because we couldn‘t
easily access his information. But if it‘s
any comfort, his information is secure…‖
Practicing medicine
Often not black and white
Patient issues tend to trump all
Significant multi-tasking
Medical training can be ―anti-business‖
training:
TV role models—break the rules; don‘t believe
what others say; find what everyone missed
Practicing medicine
Physicians need to make lots of decisions,
often fast, with limited info
Not a 8-5 job
Professionally, short time constant—what
do I have to do today?
Time constrained—don‘t have enough
Docs give realistic news, and can take it
Practicing IT
Black and white—things work or they don‘t
Hierarchical
Multi year planning
Project plans
Needs requirements
Can bog down in detail
Meet the requirements—we succeeded
Contrasting worlds
The world of IT
Specs must be clear
8 to 5 daily schedule;
standing meetings
Multi year project plan
Hierarchical, structured
decision-making
Careful diligence
Organization-driven
Paid for meetings
The world of physicians
Specs may be vague
Varying, unpredictable
schedule
―3 cases this afternoon‖
Collaborative, fluid decision-
making
―I like that sales guy‖
Data-driven
―Meetings cost me money!‖
Tough sells
―It will only take a few extra minutes…‖
―It‘s for the good of the organization‖
―Not doing this will hurt patient safety‖
―It‘s a security standard‖
Easy sells
Save you time
Make you money
Make your life easier
Helps patients (really)
Cool interface
Works well
Compelling data
Respected colleagues advocate
How to sell to clinicians
Use clinical data (that applies to their
world)
Use clinical people
Leverage respected clinicians, get them
on-board (by solving their problem)
Don‘t get bogged down in tech details
Not all physician advice sources are
created equal
Be sure your physician advocates speak
for the broader physician target audience
Understand the underlying physician
dynamics and politics
The best physician advocate—
experienced, established, medical staff
leadership track record, not a hot-head
Engage the Med Exec Committee
Engaging physicians—the big picture
Build clinical relationships
Gather informally
Choose your battles; give and take
Radical idea—treat the docs like adults!
Make sure they understand your
landscape
Be careful of strident messages from
potential outliers
Engaging clinicians—nuts and bolts
On their schedule—often early a.m.
Feed ‗em
Clear process/meeting goals, end dates
Be proactive, not reactive
? Pay docs for key participation
Support your statements with data
Running a meeting with physicians
Start and end on time—even if they don‘t
? set ground rules at the outset—
sometimes
Know who your allies are; prep them a bit
Use docs to manage difficult docs
When there are challenges, let them vent;
Know when things are simmering—don‘t
let it boil over!
Getting a message to physicians
Machine-gun approach
Med staff office
Where they eat
Where they work in hospital
Department meetings
Their office managers
Unit directors or coordinators
Simple; to the point; one page
Other potential pratfalls
Good projects can go bad for a variety of
reasons
A bad implementation can kill a good
system
A good implementation can make a fair
system succeed
Don‘t implement a ―bad‖ system
Avoid blocking/tackling missteps
Can‘t have too many workstations
Can‘t fully predict the optimal form factors
Can‘t have too fast response time
Can‘t have too reliable a network—wired
or wireless
Can‘t have too easy system access
Who owns the project?
Hopefully not IT
Things can go wrong when IT ―owns‖ a clinical
project—careful IT leader, you could be getting
set up
Things go better when the clinicians ―own‖ the
project—nurses, doctors, or a combo
Yet IT needs to manage the project – clinicians
can‘t
Best—trusted clinical/IT relationships; Clinician
leaders own; IT steers
Doing due diligence
Have to do site visits
Take clinicians on the site visits
Need their perspective
Bonding
Wander off on your own—away from the official guide
The CMO, CNO, CIO have important perspectives, but not the full perspective
Talk to multi end users
Talk to the ward clerks, secretaries—they know
Deployments
Think of deployment as a multi-week/ multi-
month process—not a three-day process
Important to circle back two, four and eight
weeks later
Best training is live training, at or right before
go-live
Best trainers are/were clinical (often
nurses)—make sure there are enough
How to kill a good initiative
Solution doesn‘t deliver ―the goods‖
Runs slowly or poorly
Training disconnected from implementation
Difficult log-ins
Clinicians don‘t know how/where to get help
Clinicians don‘t know who to turn to—who to
communicate with
Summary
Effective communication will:
Help you make the right decisions at the outset
Help you manage expectations
Help you work through the inevitable hiccups
Win advocates
Help you get it right
Make for a happier career and IT org
Not to be distributed or reproduced by anyone other than Qwest entities. Copyright © 2009 Qwest. All Rights Reserved.
Eric Bozich
August 4, 2009
CP090960 8/09
Not to be distributed or reproduced by anyone other than Qwest entities. Copyright © 2009 Qwest. All Rights Reserved.
What Qwest has Learned in Working with
Healthcare Providers
• Understand approach to serving patients first
• Work with stakeholders to develop solutions that
• Improve cost efficiencies of providing care
• Improve productivity of staff
• Result in improved patient outcomes & experiences
Not to be distributed or reproduced by anyone other than Qwest entities. Copyright © 2009 Qwest. All Rights Reserved.
Really…
• Improve Ability for Clinicians to work together
• Real Time Images
• Scan Images at the click of a mouse
• Collaborate
• Video
• Telemedicine
• Improve Ability for Staff to address increasing
demands of patients
• Call routing
• Appointment reminders
• Voice mail to e-mail
• Fax to e-mail
Not to be distributed or reproduced by anyone other than Qwest entities. Copyright © 2009 Qwest. All Rights Reserved.
How We Help IT Staff
• Help lessen the daily fires to allow for longer range planning
• Improve performance and access to applications running on the network
• Simplify Network Administration
• Consolidate communication services & vendors
• Reduced trouble tickets
• Easily add new sites to the network
• Centralize support and control while decentralizing access
• Security Services
• In partnership with IBM
• Private Networks
• Share our experience from working with many Healthcare customers
• Benchmark architectures and communication platforms
• Advise issues other providers are seeing, what they purchased to resolve
and results they received
• Provide dedicated account teams, service support and best in class migration
and project management help
Questions?
Not to be distributed or reproduced by anyone other than Qwest entities. Copyright © 2009 Qwest. All Rights Reserved.
To learn more about Qwest Healthcare
solutions, visit:
www.qwest.com/healthcare
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