Time Capsule: A Day in the Life of IT-Visionary Hospital VPs: Laying Out CPOE Benefits to Luddite Doctors

I wrote weekly editorials for a boutique industry newsletter for several years, anxious for both audience and income. I learned a lot about coming up with ideas for the weekly grind, trying to be simultaneously opinionated and entertaining in a few hundred words, and not sleeping much because I was working all the time. They’re fun to read as a look back at what was important then (and often still important now).

I wrote this piece in July 2009.

A Day in the Life of IT-Visionary Hospital VPs: Laying Out CPOE Benefits to Luddite Doctors
By Mr. HIStalk

Doctors are such whiners when it comes to computers. Everyone can see that. Resisting the use of CPOE and EMRs is just silly in this day and age where everything is done on computers.

This recently came to a head at my hospital. The CEO got a voice mail from a peer at St. Roxy Hospital, left on his desk by his executive assistant, who transcribes all of his messages.

St. Roxy was mandating CPOE, he read, underlining the word “mandatory” since it was important. Doctors need to do all their work on computers instead of the paper chart. There were too many errors and too little opportunity to oversee their work by monitoring electronic databases.

My CEO responded decisively, leaving his executive assistant a Post-It note on her monitor right beside the one holding her current password, asking her to schedule a meeting with all his VPs about CPOE. She was asked to prepare a relevant PowerPoint presentation and attend the meeting to run the laptop.

The executive assistant e-mailed all the VPs to ask them when they would be free for an hour in the next two weeks. It took a week to get all their replies since some were out of town and hadn’t set their vacation alerts.

One was late in responding because her top-of-the-line hospital laptop had failed after her teenaged son had used it for several consecutive hours of doing Internet research for a school project in his locked room, necessitating a call to the VP-only IT support hotline so that a technician could be dispatched to her house on a Friday evening.

Once the meeting finally occurred, everyone agreed that it was time to take a hard line with CPOE-resistant doctors. The marketing VP took minutes, asking to have someone type them up because he doesn’t have a PC in his office since it clashes with his executive furniture.

The CPOE software vendor was the problem, the COO decided. He had his assistant arrange a Webex with the vendor after having her call the CIO to find out what vendor had provided the $20 million system. It started late because several of the VPs needed personal help getting connected. Once on, the vendor’s sales VP apologized that he would be not be able to see the PowerPoint because he was on the road, where he doesn’t like carrying a laptop.

The solution, it was decided, involved tablet PCs and speech recognition software. The CIO had never used either, but recommended that the CEO order some of both for doctors to try. Since the CEO was running late for his 5:30 tennis match, he asked his executive assistant to get on “The Google” and order some copies. She asked if it was OK to work an hour of overtime to get it done since she was responding to a Wackovea request to send in her account’s user name and password to avoid having access to her checking account frozen. He agreed, telling her to draw up a check request and leave it in his inbox to sign.

The CIO was tasked with putting some kind of graph on the executive dashboard to monitor the progress. He wasn’t too worried about it since executives rarely looked there anyway. He had asked them whether they found the Intranet useful, but all the VPs replied that as leaders, they relied on instinct and their skills at understanding people to make decisions rather than graphs.

Everyone felt good about the progress that had been made in helping doctors understand their vision of shifting their income-earning patient care activities to computers. So good, in fact, that the CEO decided to publish his thoughts on CPOE to his widely read blog, which will happen just as soon as his executive intern finds the time to write something up for him.