EPtalk by Dr. Jayne 5/24/18

I’m having an ongoing debate with one of my clients regarding communication. Over the last several years of their major IT rollout, they’ve been sending out a biweekly newsletter informing stakeholders and users of what is going on with the project along with general information about regulatory and incentive programs such as Meaningful Use, MIPS, and more. The newsletter is relatively brief, but has links out to all sorts of other materials for interested readers. Users are initially opted in to the newsletter when they are hired, but have the option to unsubscribe if they desire. Looking at data over the last couple of years, the open rate is actually pretty good for an email newsletter.

Recently, however, with a move to a new infrastructure platform, they’ve had issues with outages and have been sending all kinds of downtime bulletins and outage notices. As one might expect, users have complained about the volume of communications as users feel peppered by announcements. They particularly dislike announcements that may or may not relate to them – for example, a member of the physical therapy department receiving communications about a laboratory outage.

As a result, the communications team began a project to reduce the volume of communications. Their first target was the biweekly newsletter. They’re still creating the newsletter, but they’re just not going to email it to people any more. Instead, they expect users to go to a static link periodically to see what is going on.

When I initially heard about the plan, I had concerns about this approach. For one, people are busy and may not remember to look at the information. Since the content changes every two weeks, users who want to keep up with the news would need to make an appointment for themselves or set up another reminder system. I asked about ways to publish the link or make it more accessible, such as including the information on the images that display when monitors go into screensaver mode, or making it a start page when browsers are launched. They were not open to considering either of those, so I also asked about adding a desktop shortcut, so employees wouldn’t have to create their own. That also got shot down.

The second reason I was concerned is that there were people that received the newsletter who aren’t end users but would benefit from the information, such as administrative leaders or other members of the management team. Those individuals probably weren’t getting the outage notifications or other emails, so there may be other factors in play.

I admit I was getting a little frustrated, so I asked if they had done any work to analyze exactly what the volume of communications is or to categorize them before taking a seemingly random approach to eliminating communications strictly in the name of volume reduction. Had they looked at how many emails were part of outages vs. how many informational, vs. how many were not even related to the project? Maybe the email volume was related to other entities, such as the various hospitals, the employed physician group, or other shared service providers. such as security or the facilities and maintenance group. It turns out my suspicion was correct — they had made the assumption that the issue was the project’s problem.

I got them to agree to take a look at data before they made their decisions, so we are working with the IT team to begin monitoring some of the email traffic. We should know in a couple of weeks what the real problem looks like rather than trying to operate on assumptions.

Far too often I see these kinds of decisions that are made on hunches or using assumptions rather than data, even when data might be available for the asking. Although scenarios like this one can be anxiety-provoking, they can also be one of the most fulfilling parts of consulting. When you convince clients to act on something that they haven’t thought about or that might really change how things turn out, it can be gratifying. Having a communication plan can be challenging for many organizations – I only find an actual written communication plan with about half of the clients I engage. Knowing the best ways to get the word out to your stakeholders, users, and other constituents is key to the success of any project. I’d be interested to hear what readers’ favorite communication strategies are, especially in thinking about how to keep things fresh on massive, multi-year projects.

A former classmate sent me a link to this story about strategies that Yale School of Medicine is using to improve physician satisfaction. It was being circulated at her organization as being relatively “revolutionary” advice. After reading the article, I hope my classmate’s IT and leadership organizations are ready to explain why they haven’t rolled out technologies that many of us take for granted and which are almost mandatory for high-performing organizations. After a system-wide analysis of the problem, Yale decided to implement login efficiencies with proximity badges, saying that traditional logins “had a disproportionate effect above and beyond the time with just the annoyance factors. Addressing this psychologically, as well as time savings, has been a huge win.” I’ve worked at hospitals with proximity badges for more than a decade, so it’s a bit surprising that an organization of this caliber wouldn’t have it.

They’ve also added speech recognition technology connected to the EHR, allowing a 50 percent reduction in the time needed to complete encounters. Speech recognition has a 30-40 percent adoption rate at Yale. There is a push for physicians to use the technology while patient-facing to aid patient engagement. This approach is a little more revolutionary for some organizations, but I’ve worked with clients who use it and it’s been very effective.

Their third strategy is to pilot virtual scribes, with 50 physicians in the program. Yale is doing other work to improve physician satisfaction, including communication training and programs to build clinician resiliency. They’re also providing meditation programs and mindfulness workshops. I’d be interested to see effectiveness data on the latter two offerings.

Does your organization promote meditation and mindfulness? Leave a comment or email me.

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