In a program as complex as that currently underway to encourage adoption of EHRs and Health Information Exchanges in the U.S., extensive planning and open, transparent, honest discussion are crucial to success. As logical as this may sound, it is very difficult to keep large programs moving while providing sufficient flexibility to make the necessary adjustments. Even as Stage One of Meaningful Use awaits introduction, work is already beginning on the definition of Stage Two. Eliciting feedback and implementing adjustments takes time, a commodity in short supply under the stringent requirements of the current program.
One aspect of EHR adoption that has not received much attention is that of creating a practice culture conducive to success. For many practices, adopting an EHR is a formidable and disruptive process. Every practice has a structure and team culture that result from working closely together. When implementing an EHR, relationships in the practice can be significantly stressed as a result of changes to workflow, job descriptions and responsibilities. How the practice responds is dependent on how the team works together. In order to optimize and maximize the benefit of an EHR, a clinic will need to re-think how the clinic team will need to work together. This step can easily be missed as the activities of EHR selection, contract negotiation, and implementation absorb the clinic leadership and staff. However, developing a culture that is able to respond to challenges without losing sight of the end objectives is crucial.
Are there common cultural characteristics that are present in practices that have achieved success in the adoption and use of EHRs as well as other health information technologies?
The following should be considered:
- Mission, Vision and Values: Articulate your clinic vision and ensure that all members of the practice team (clinicians, administrative, and support staff) buy into the vision and practice goals. This will become your foundational reference when difficult decisions have to be made, particularly if they involve the firing or hiring of staff.
- Communication: Regular formal and informal communication is necessary to keep all practice members informed about progress, challenges, successes, and failures — and what is going to be done in the event of a setback. Communication should involve scheduled face-to-face meetings and written or email updates. Knowing the status of the practice will reduce anxiety and will allow individuals to adjust their readiness for specific tasks.
- Rewards and Recognition: Do you have a practice culture that recognizes personal performance? This can be a strong motivator and will allow motivated staff to strive towards achievement of personal objectives. Rewards do not have to be financial, but can include recognition in intra-practice communications, being selected to lead specific aspects of the EHR adoption process, or offers to attend seminars or conferences on behalf of the practice.
- Training and Continuous Learning: It is important to establish a culture of continuous learning. EHR implementation is a commitment that will impact everyone indefinitely from that point forwards. Continuous learning can be achieved through external education — attending user group meetings and advanced vendor training sessions. It can also take place internally through advanced or “super users” taking time to train colleagues and office staff on more advanced EHR functionality.
These are just a few characteristics of a healthy practice culture. Do you have any experiences to share that have been particularly useful to your practice culture? Add your thoughts by clicking on the Comments link below.
This post is the personal opinion of the author and does not necessarily reflect the official policy or position of the American College of Physicians (ACP). ACP does not endorse a specific EHR brand or product and ACP makes no representations, warranties, or assurances as to the accuracy or completeness of the information provided herein.