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They can cost as much as buildings and there are many stakeholders. But good IT implementations are possible if the right people are involved and excited, said presenters at the Digital Healthcare Conference
produced by WTN Media.
"User ownership is absolutely essential," said Peter Strombom, CIO of Meriter Hospital
. "If the users don't know the application, if they don't feel they're being heard, you're going to have trouble when you go live."
When the users are physicians, implementers often confront a reluctance to change existing practices, especially when it might require spending more time entering data into fields on a computer or handheld device than they would spend writing it down or telling someone.
"Physician adoption of IT is very different from the way I think they approach other things," said Judy Murphy, vice president of information systems for Aurora Health Care
. In a morning session, she wondered aloud how she would explain to a new CIO that in 10 years the hospital has gotten 400 of 550 physicians to use computerized systems.
The approach that Murphy and many participants at DHC take is to emphasize the process and people problems over the technology.
"The purpose of doing the project should be all about the clinical reason why it's being done, and the IT just the enabler," Murphy said.Making the case: physicians
"Many times, IS people have come forward and think, without practicing medicine, they are going to solve problems physicians haven't identified," said Mike Sauk, interim CIO at the University of Wisconsin Hospital and Clinics
. "And it's a solution chasing a problem."
But get the physicians involved and, perhaps more importantly, give them something that they believe improves their effectiveness, and they will rally around the project.
One of the successful projects that Donna Sollenberger, president and CEO of UW Hospital and Clinics, recalled was at MD Anderson
, where she was vice president of hospital and clinics. While reinstalling a scheduling system, they put a design document on large sheets of paper in the physician dining room with plenty of pens and asked for feedback. Comments poured in, and though many were contradictory the feedback helped design a system that better met the actual needs of physicians - and got those physicians more excited about the project.Making the case: in the boardroom
When it comes to pitching executives, no tech jargon is allowed. But not only do CIOs have to be able to speak the language of business - they need solid financial and medical justifications for the IT systems they're proposing, as well. Especially as a new IT system can have a huge financial impact.
"It's competing on your capital chart with buildings," Sollenberger said.
On the budget sheet, IT does not always get credit for increased revenues due to more efficiency or IT capabilities. But conference chair Barry Chaiken wondered during a session on Thursday whether healthcare IT is simply becoming a necessary part of health care - like trucks for UPS - and thus not subject to the same return-on-investment calculations as other purchases.
If, that is, the ROI calculations can accurately measure the impact of IT projects in the first place, when requirements can change over time and there's always room for the unexpected. "I've always been amused when I've gone back and looked at the ROIs we did," Sollenberger said.