Clinician Training an Important Investment When Implementing Technology

The benefits of IT are many, but so are the administrative burdens. Physicians leaders should allow providers protected time away from clinical care to support the effort.

Imagine a world where electronic data can predict population health concerns. Where smartphone apps allow vitals to be monitored in real-time from a patient’s home. Where artificial intelligence can help make decisions to improve health outcomes.

These scenarios aren’t so futuristic. And physician leaders are in an excellent position to make decisions to best make use of such developments in the move from volume- to value-based care.

But the benefits don’t just come with the click of a mouse.

Technology is an enabler, but there are lot of workflow infrastructure requirements that still need to be met, says Michael Bakerman. MD, chief medical officer at St. Elizabeth's Medical Center in Brighton, Massachusetts.

“Some of it requires technology. Some it just requires good old-fashioned communication and adherence to best practices,” Bakerman says.

Joseph Kim, MD, MPH, MBA, the president of Q Synthesis, a health care education and quality improvement company, says there’s considerable resistance around health care IT because of the administrative burden.

“We see now published literature and studies around how health and EHR leads to physician burnout as well as increases physician workload and their time,” he says. “From my perspective, I think it’s to make everyone on the team more technology-literate.”

That requires an investment in time for physicians to get away from the clinical setting, says Byron C. Scott, MD, MBA, CPE, FACEP, FAAPL, deputy chief health officer for Simpler Consulting, part of IBM Watson Health. Scott also is a member of the American Association for Physician Leadership’s board of directors.

“You have to have times where physicians have protected time from clinical care to support the efforts, he says. “It’s a matter of … making sure there is time and funding for clinical leaders, especially physicians, to have additional training and certification in health care IT.”

Scott says it’s important to employ a chief medical information officer or vice president of informatics to support clinicians and make decisions.

Kim agrees, but he believes the workflow must spread beyond the C-suite.

“You certainly need assigned leaders,” Kim says. “But below them I think you need to make sure that people really thinking about the benefits that are offset by all these tradeoffs that technology offers. Are there processes or best practices you can share to help others develop health care business practices to make IT implementations effective, compliant?”

Feedback and inclusion are key.

“Where leadership, administration sits down with the actual end users and in some cases even with patients, gathering feedback directly from those who will be using these systems day in and day out,” says Kim, a member of the AAPL faculty.

“A lot of times, this ends up being the average physician as well as the nurses on the floor or in the outpatient settings and really gathering feedback from them so that both leadership and administration can sit in a room and listen to them directly, but also be more cognizant and make more informed decisions.

“… When that day comes for you to either go live or to start making these changes, you have people at that ground level who have contributed to the whole process.”

Bakerman, an AAPL faculty member, suggests that physician leaders try and stay as connected as they can to the front line. Do safety rounds or leadership rounds - just experience the workflow with the clinicians.

Otherwise, “you lose the sensitivity to what the front-line worker is doing with workflow, with all the challenges that IT brings to people.”

“Our nurses, our providers, residents are just struggling mightily under the weight of a broken, fractured workflow, limited information, bad information, and it’s a major frustration,” he says.

Bakerman also recommends nurturing individuals on the staff who have an interest in IT.

“I think you need to really support them and encourage them,” he says. “That may be training, education courses, exposure to conferences where people are really talking about what’s going on in technology today. It’s different than what you’ll see in medical school or most of our clinical conferences.”

Rick Mayer is a senior editor for the American Association for Physician Leadership.