Readers Write: The Pitfalls of Resource Labeling in EMR Projects

The Pitfalls of Resource Labeling in EMR Projects
By Tyler Smith

In enterprise-wide EMR software implementations, the labels “clinical” and “technical” are often utilized in an attempt to categorize the project’s human resources. When taken to improper extremes, these two labels can give rise to an unhealthy “us vs. them” mentality among project team members which can be highly detrimental to the project’s timeline and team member cohesion.

The us vs. them mentality can hardly be considered de facto in enterprise EMR software projects. The division of clinical and technical team members is often intentionally defined by the leadership of large scale enterprise EMR projects. The division is worked into the project’s staffing plans and subsequent role assignments. There are often defined minimum numbers of clinical and technical team members for each of the project’s teams.

The justifications for role assignments based on clinical or technical skillsets are obvious. A project needs individuals with hands-on experience in the areas where the software will be applied in order to give a necessary perspective to builders and PMs, as well as to increase the legitimacy of the final product. A project also needs individuals with sharp IT skills who can translate flowsheets and labs, along with about everything else in these HITECH days, into computerized workflows. Ownership is important on IT projects, and the labels add ease to the sometimes difficult assignment of ownership.

What I fear most about the division is not hurt feelings, although I’m not saying that hurt feelings can’t directly result from the intentional division. What I really fear is the waste of resource time the labeling can cause if it is taken to its extreme.

Although mostly absent from Washington these days, the willingness of team members to compromise and sometimes share ownership is essential in divvying up tasks between clinical and technical team members. While some project tasks can be clearly divided – and these areas are no doubt a huge reason for the pronounced division – there are often gray areas that are not so easily categorized.

Battle lines are drawn when a group is delegated the task of owning a project or heavily assisting with an assignment that they do not believe is aligned with their label’s responsibilities. I have seen technical team members who refused to complete orders build based on lacking clinical knowledge. I have seen clinical team members refuse to perform easy interface cleanup based on lacking technical skill.

While both of these team members were right to the letter of the law, the project’s thin resource allocation necessitated their somewhat misplaced assignment. When it came down to it, given a little bit of willingness to learn, each team member could have accomplished either task. Validation would have been required, but the compromise would have saved hours of argument that waste resource time and increase the project costs.

Therefore, while divisions may be necessary to create a neatly formatted organizational chart or to meet certain artificial quotas, a culture of flexibility needs to be promoted in concert. Technical people should be encouraged to Google healthcare topics a little more and clinical people should not be afraid of reading up on computer languages.

Deference to each other’s expertise remains a given, but showing respect by attempting to learn the other side’s language goes a long way. After all, team members are not made members of the project to simply live to a label. Project members exist in order to facilitate the project’s ultimate success.

Tyler Smith is a consultant with TJPS Consulting.