EHR systems are a force to reckon with for a large number of healthcare providers. While the convenience and efficiency offered by these systems are encouraging, there are complexities that are overwhelming for physicians. For instance the ease of access and sharing patient data enabled by the EHR is a great option for medical peer review physicians among others who need medical record access. However, the natural resistance to change, difficulties involved in understanding the system, and costs involved are some of the factors that delay EHR implementation in healthcare organizations. While the transition from paper to electronic records itself is challenging for many physicians, moving from one EHR to another is an even greater challenge. Even so, physician/clinician engagement is crucial for EHR implementation (because physicians are the major force behind most healthcare quality and cost decisions); though engaging them can be intimidating.
If the EHR is not properly implemented, the organization can run into huge problems including internal conflicts between the management and staff, and financial issues. A comprehensive understanding of the various stages of EHR adoption and a strong strategy to take the physicians through the disturbed waters are the major requirements for physician engagement. Since EHR implementation is a system-wide change, hospitals and health systems are very likely to experience delays in patient care delivery and disruptions in the workflow of clinicians. But this is only temporary and physicians should be made aware of this fact.
How can physician engagement be encouraged in this context?
- Create awareness about the need for EHR implementation. Clinicians must be made aware of the developments in the healthcare marketplace and also about your competition.
- Encourage influential physician leaders who have already adopted the EHR system to help you create and convey the vision for change. These leaders can help your physicians understand the benefits the system can bring them.
- Give sufficient training time and allow physicians quality time to get familiar with the new system. Before going live, physicians should have the time to practice the new skills they have learned. They should also be given the opportunity to customize their systems. It is important to understand that immediate productivity cannot be expected, and make sure that the physicians are not put under too much pressure.
- Conduct EHR usability tests during development and after implementation. This will surely simplify EHR use, as data from Pew Charitable trusts show.
- Once the EHR is implemented, make sure to mention the progress being made with the new system. Give due recognition to physician leaders responsible for achieving success. Encourage the physicians to provide feedback and suggestions for improvement.
A successful EHR implementation story is that of New Jersey-based Virtua Health System that replaced its diverse health IT systems with a single unified Epic EHR system. This organization found that selecting an EHR vendor that best suits the particular needs of a healthcare organization’s patients and providers is the most important consideration when implementing EHR. Virtua considered the feedback of its staff as regards which system best fit the Virtua environment, during its own EHR selection process. Since clinicians were involved in the implementation process, they could ensure the Epic system was ideal to meet clinicians’ needs surrounding health data exchange, EHR usability, and EHR integration.
Immediately after the go-live, Virtua began training its clinicians on the Epic system. The providers were quickly able to adapt to the system and start utilizing diverse Epic modules to improve care coordination, clinical decision-making, and patient engagement. As Virtua Senior Vice President and Chief Information Officer (CIO) Tom Gordon says, “To just go out and switch an EHR just for the sake of switching is a disaster waiting to happen. You need to clearly define what you need to accomplish. We knew we wanted to better align with healthcare reform, increase communication and care coordination, and integrate to best tell the patient’s story.” He stressed the importance of communicating with clinicians before EHR implementation to ensure they understand the objectives of the project. Clinician engagement will be minimal if they feel that the health system is unnecessarily investing in new technology.
A medical review company serving clinicians understands that change is challenging for physicians who have been experiencing a multitude of changes over the past few years. To drive engagement and EHR adoption, health systems must build trust, demonstrate common purpose and develop a close association with physicians.