CIO Unplugged – 6/1/08

The views and opinions expressed in this blog are mine personally, and are not necessarily representative of Texas Health Resources or its subsidiaries.

Got Clinicians?
By Ed Marx

If you don’t, you should. How many credentialed clinicians should a healthy IT department have? We presently have twenty percent—MDs, RNs, Radiology, Medical and Pharmacy techs, Pharmacists, therapists and a smattering of other less common specialties. I’m pushing to raise that figure.

I was recently requested to be the keynote speaker at a Nurses Week celebration at one of our system’s hospitals. Being a keynote is an honor in itself. But for me, speaking to the caregivers of our patients put this opportunity over the top. Although my presentation did not rank at what I’d have labeled top notch, preparing for it proved invaluable. It reinforced my admiration for caregivers, especially nurses. It also reminded me to permeate my IT staff with clinicians to ensure that our labor is accomplished with the caregiver in mind.

I long for the day clinicians are present throughout IT, including technical domains such as networking, data center, and other atypical areas. True, they are more dominant in application areas, but why limit the potential? The blending of clinicians with technologists could lead to higher levels of transformation and innovation. Here is our most recent revolutionary venture: we just added a physician employed by our organization that possess clinical and technical skills and leadership talents, and who will work closely with our CTO. I’m watching eagerly for the effects to unfold over the next few months.

Okay, so you’ve read the existing articles on how clinicians benefit an IT staff. But once you have them, how do you best position them and your traditional IT staff for success? What are the inherent challenges for clinicians and IT?

Note: Are you aware? When a clinician comes aboard as an IT staff member it is equivalent to starting a brand new job?

Think back to your own job changes. Could a swim coach apply her swim skills to her new waitress position? What about a massage therapist employing his talent in a paralegal job? Keep in mind this concept as you read the following practical tips on clinicians joining IT as shared by one of our clinicians, Diana Gibson, RN…

Challenges for Clinicians:

· Adapting to the office environment

Cubes vs. nursing station reduces the sense of teamwork

Use of meeting rooms is equated with loss of casual social interaction

Taking work home

Going out to lunch vs. grazing between patient care tasks

· Difficulty recognizing accomplishments/results

Need to understand the bigger picture (see beyond the patient)

IS systems are configurable with lots of gray areas; reduced workflow focus

No more rapid results (average patient los is 3 days)

Used to implementing changes quickly

Giving up precision and timing on tasks

· Loss of familiarity generates stress. The clinician must:

Learn new tasks, find new resources, and create a new employee network

Learn basic IT software (No more IVs)

Fight pressure to already understand IT on the first day of work

Assimilate IT language/acronyms

· Facilitation skills are not in the typical nursing repertoire

Scheduling appointments

Creating agendas

Taking minutes

Using a meeting room to solve problems as opposed to on-the-spot interactions

· Common conflict areas and issues of concern for clinicians

IT staff is generally unaware of clinician’s former environment and the required adjustments

Lack of training for clinicians in IT subjects

Clinicians are expected to already know what to do

Downtime scheduling affects issues regarding patient care

Clinicians have an inherent desire for more testing on software/applications (like testing a drug before giving it to a patient)

Bridging the gap and investing in clinicians:

Preceptor program

Increase depth of typical IT orientation

Pair new clinical staff with experienced IT person; identify future clinician leaders

Document and publish referable guidelines

Create web based training on IT tools

Project Management Training

Create PM processes that nurses/doctors can relate to

Help user/clinician visualize the big picture and break it down into tasks

Professional Development

Develop a Facilitation/Leadership class

Provide Continuing Education Credits (CEU)

Create internal training opportunities specific to clinical IT

Develop clear development pathways, like a clinical ladder

Clarify the position’s responsibilities

Embrace the significance of melding clinicians with IT. Be more intentional with it, maximize the value, and encourage further adoption. A healthy mix is a key to a high performing healthcare IT organization.

Got Clinicians?

Ed Marx is senior vice president and CIO at Texas Health Resources in Dallas-Fort Worth, TX. Ed encourages your interaction through this blog. (Use the “add a comment” function at the bottom of each post.) You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook, and you can follow him via Twitter – User Name “marxists.”