Alignment with all clinical departments.
How to engage all clinical departments to embrace the Electronic Health Record.
As department of health informatics, we are responsible for the Electronic Patient Record ( EHR). We support all clinical entities of our organisation. To provide the best support we need close interactions with the key players of these clinical entities/processes.
However, not all clinical departments have embraced the EHR and invest in improving the EHR for their own work process. As a result, some departments are advanced in using the EHR while others are still struggling. These less-EHR-dedicated departments do tend to complain about the service of our department of health informatics and they also tend to blame the EHR of many ( obviousy not EHR related) issues.
Example
The executive board invited all department presidents for a meeting with the board of directors, the CMIO and Quality officer. The agenda of this one hour individual meeting incuded the EHR and Quality management. The email for this meeting was send from the department of health informatics. Some 4 of 24 presidents had not read this mail since mail from the department of health informatics was always ignored!
The question is how to engage all clinical entities in order to let the EHR grow into a benefit in stead of an expensive notewriter.
I wonder if you could develop a positive reinforcement structure where using EHR would be rewarded financially? I.e. if your notes are done by 4 business days/95% of time, you receive x $/quarter? The engagement of the department presidents have to be assured from the top leadership- i.e. IT is unlikely to be able to truly engage someone who is not under their supervision. Sounds like the top leadership needs to analyze the situation, see if there are potentally resources lost because of the lack of engagement, or resources to be gained when engagement is full and take action.
You need to establish a win-win relationship with those departments that are reluctant to embrace EHR. What is in there for them that you could highlight and will tip the balance? Are there publications you can get from data mining in EHR?
One potential idea would be to try to better understand the typical user experience in each clinical department (ideally with a sample of some of the efficent, high quality documenters as well as the less efficient documenters who struggle with technology) and then try to optimize that department specific user experience within the defined limits of the EHR. That would require trying to use some of the user experience data that you have (if it is available) and potentially some user survey data to help define the range of experiences on the EHR for each clinical department. If clinical departments could then identify a couple super-users that would then give active, meaningful input into improving the user experience their department team members, this approach could help improve engagement and decrease some of the frustration within each clinical department. I suspect one of the challenges will be the variable (or lack of) adaptability of the EHR to each clinical department. It is worth exploring.