By Amy Maneger, MD, Advisor
EHR success is less about reducing clicks or whether the vendor has created the perfect UI; recent data from KLAS reveals that culture plays a much bigger role in physician satisfaction.
Some organizations have tried to make a difference by optimizing the software and/or the IT team only to find that no significant changes follow.
I believe we too often overlook a crucial aspect of leveraging an EMR: physician ownership and engagement. A healthcare organization needs to have physician ownership and engagement in the content as well as the functionality of the EMR, in order to have an EMR that supports their users in providing quality care.
Step 1: The Role
Ideally, every specialty in a healthcare organization should have a physician with some degree of “ownership” as well as extensive knowledge of the EHR.
Customize Roles to Your Organization
Every successful physician-owner program will include some key components, but one size will never fit all. While preparing to build a clinical informatics team at one organization, background research among CMIO compatriots, revealed that each health system had its own “flavor” of ownership/engagement.
For example, some vendors strongly recommend physician builders. This role has indeed worked wonders for many health systems. However, some organizations find it too expensive or otherwise unrealistic to have a crew of physicians performing significant EMR configuration.
Other organizations have adopted a role, that I like to call the “physician architect”. This person may not be involved in the actual hammers-and-nails work of building the EHR but is instead responsible for helping design clinical decision support and other solutions to support quality and process improvement endeavors.
There are other roles that may be less labor and time intensive but still ensure physician satisfaction for their specialty area.
At one organization, we had an Epic Medical Lead role. This was a 0.1 physician FTE who had robust knowledge of Epic functionality, owned the medical content for their specialty (i.e. preference lists and order sets), and could assist in the development of advanced training content as well as tools to enhance provider efficiency and the quality of clinical care provided.
It’s important to note that the physician roles do not necessarily need to be the same across the organization—there can be some mixing and matching in different areas or specialties.
Step 2: Who to Recruit
For the best results, you need someone who wants to be in the role. You need physicians who want to make your EHR the best it can be and help their fellow providers use the tools effectively. They should have a passion for improving the status quo and want to be part of the solution!
In addition, they should have the support of their physician leader. If the division head or department chair doesn’t support them in this role, success is much less likely.
In selecting your physicians, set up a few relevant steps and requirements that candidates must complete before qualifying for their new positions. After all, only candidates who really care are willing to jump through hoops.
In addition to a good process for finding and selecting the right people, these doctors also need to be given the time to do the job! Typically, this means that some percentage of their role is dedicated to informatics. In some organizations, they are compensated for the additional time spent on informatics.
Step 3: Set Expectations
It’s important that HIT leaders clarify what goals these physicians need to accomplish, how to accomplish them, and what success will look like. They need to feel needed and need to understand that if they don’t do their jobs, nobody will. In short, these physicians must feel accountable for the success of the EHR.
Step 4: Empower the Physicians
In order to fill their new roles well, these physicians ‘owners’ will need education. This may come in the forms of training, coaching, and mentoring, as well as some advanced education about their EHR.
They have to understand the difference between small issues that can be fixed without much ado and bigger problems that will take outside help. They need to know the chain of command as well as your IT processes. Treat them as if they are inside the ‘IT firewall’. This knowledge will imbue them with confidence.
It’s also important that these physician champions get enough tools and decision-making power to have an impact. Empowered physician owners create more empowered physicians.
A Few Will Benefit Many
Some might say, “Sure, turning a few doctors into physician builders, architects, or medical leads might get those physicians more involved with EHR improvement. But will that really get all of our physicians more engaged?” My answer is a resounding “Yes!”
When physicians know they have a fellow physician as a resource—someone who knows the EHR, shares some of their personalization tools, shows their peers some easy wins, is connected with the IT team, and is familiar with IT processes—they feel much better about the EHR. In addition, with physician’s owning the content, you will have a much better quality EHR.
Even better, they’ll know that one of their fellow doctors will advocate for the changes that really matter and then help train their peers on how to apply those changes.