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What to Expect When You are Expecting: The Challenges of Technology Adoption Across A Dispersed Organization – Breakaway Thinking

Posted on October 26, 2016 I Written By

The following is a guest blog post by Mark Muddiman, Engagement Manager at The Breakaway Group (A Xerox Company). Check out all of the blog posts in the Breakaway Thinking series.
Mark Muddiman
Imagine you have just installed your new clinical information system. Everyone has been waiting for months and excitement has peeked; the big day is right around the corner. Go live is coming and all the organizational sites are prepared for the new workflows and application. The application goes live and suddenly everyone needs help, support is inundated, and it becomes apparent that the expectations were not aligned to the reality of preparedness.

All too often this is a common scenario for organizations that are dispersed over large geographic areas. Adopting healthcare technology is difficult in a singular location, but certain challenges are uniquely amplified when an organization is dispersed. What challenges can you expect related to adoption and learning, and what can you do to ensure you are prepared?

Expect a greater emphasis on change management
As HIMSS reports, individual sites may fight the loss of autonomy as everyone is brought to a standard application or workflow. Each location has developed their own way of using the legacy application, and they must now learn new procedures and processes in addition to a new application. Multiple locations present multiple groups to manage at a distance, without the ability of physical project team members to be present at all locations throughout the adoption process.

Expect deviations from best practice and follow-up learning
Medical Economics recommends that learning continues beyond the initial go live. Staff will deviate from the best practice workflows as they forget less common tasks, and learn to navigate and use the application in different ways. Deviation from workflows introduces inefficiencies, dependency for support, and impedes the ability of staff to rotate between locations because the experience differs. Anticipate a need to provide follow up learning that reinforces best practices and helps avoid poor use of the application.

Expect each location will need onsite support
During go live, staff will often forget where to start and need a source to turn to when they forget a step in the new application and workflow they are using. However, it is very expensive and likely impractical to have a project team available at each location. Instead, providing assistance through super users and clinical champions along with easily referenced education materials will provide accessible onsite support for most issues.

What can you do?

Bring local leadership into decision making
Regional and local leaders can clarify the unique needs and constraints of their site when selecting applications and designing workflows. Whether equipment varies at each site or there are different service offerings, there are multiple benefits of involving local leadership. It allows leadership to determine the appropriate level of standardization that still respects the unique needs of each site, consequently removing the necessity to deviate from the standard workflow. Involving local and regional leaders engages them, provides a sense of ownership and cooperation in the project, and will help reduce resistance to change. It is imperative leadership is aligned at all levels, engaged in the adoption process, and supportive of the approach if adoption is to succeed.

Implement and ensure metrics are utilized
Metrics serve as key indicators to progress, knowledge retention, and proficiency, but in dispersed locations metrics also serve as indicators that would otherwise be filled with in-person observation. Metrics show whether a location is developing poor workflow practices or struggling with the change; subsequently metrics indicate whether a site needs additional support or learning. New metrics may be employed, such as surveys to gain feedback from multiple sites that could otherwise be obtained from a meeting or observation.

Follow up with each location often
Some sites will likely be more vocal in their need of support than others. It’s important to follow up with all sites and provide remedial education if metrics indicate a need to do so. Staff may need refresher training if inefficiencies arise, but there may be a root cause such as an educational or workflow gap that was previously unknown. Because adoption is a long-term commitment, it is important to provide continuous availability of learning while sustaining content to support changes to the application and learning needs.

Employ communication from leadership effectively
Effective communication goes a long way in reducing resistance to change. It also provides a channel for feedback and continuous collaboration. Communication should come from executive leaders to show their support of the adoption initiative, but also from local leaders. Staff can’t stop operations in a healthcare setting to join conference calls, and emails aren’t always read, but local leaders are able to directly communicate with staff. A comprehensive set of communications ensures an aligned message at all leadership levels and improves the ability of messages to reach staff.

While these suggestions may help, there is a proven methodology to comprehensively address challenges. At the Breakaway Group, we work with leadership to support engagement and change management at all levels while providing comprehensive sets of communication. Our experienced teams can provide workflow recommendations and develop education directly from the application that is sustained through the life of the partnership. Real-time data and metrics provide indicators of how each location is performing and undergoing change. Regardless of the organizational structure or of what to expect, we employ a methodology to help any organization achieve successful technology adoption and value realization.

Xerox is a sponsor of the Breakaway Thinking series of blog posts. The Breakaway Group is a leader in EHR and Health IT training.

The Senate is Promoting Healthcare Innovation – How Organizations Can Keep Pace – Breakaway Thinking

Posted on April 20, 2016 I Written By

The following is a guest blog post by Mark Muddiman, Engagement Manager at The Breakaway Group (A Xerox Company). Check out all of the blog posts in the Breakaway Thinking series.
Mark Muddiman
On March 9, 2016 the Senate Committee on Health Education Labor and Pensions (HELP) approved S.1101, better known as the Medical Electronic Data Technology Enhancement for Consumers’ Health (MEDTECH) Act. As HIMSS reports, the bill aims to limit the regulatory oversight of “low-risk” medical device software, while simultaneously making a clear distinction of the FDA’s reach of authority.

But how do you define “low-risk” when it comes to a person’s health?

The answer might surprise you. These items are deemed low-risk by the MEDTECH act and will no longer require oversight:

  • administrative, operational, or financial records software used in healthcare settings
  • software for maintaining or encouraging a healthy lifestyle unrelated to medical treatment
  • electronic patient records, excluding software for interpreting or analyzing medical image data
  • software for clinical laboratory testing, excluding software for interpreting or analyzing test data
  • software that provides medical recommendations and the basis for those recommendations to healthcare professionals, excluding software for acquiring, processing, or analyzing medical images or signals

Regulations serve a purpose in ensuring that the devices used do not put patients at risk, and some fear that the loosening of these restrictions could be problematic. But the number of policies vendors were previously required to abide by was staggering. There is little value in subjecting vendors or healthcare leaders to such stringent policies with software and devices that are unlikely to lead to increased risk or an adverse event. Unnecessary regulation ultimately restricts patient access to the most current technology and impedes more successful clinical outcomes.

As HIMSS further clarified, the MEDTECH act still allows the FDA to oversee medical software if it considers the product “reasonably likely to cause serious adverse consequences.” The congressional summary goes on to note that the FDA may assess a software function for safety and effectiveness if the medical device has multiple functions. For example, mobile applications do not need supervision if integrated by a vendor unless they become linked to something of medium or high risk such as medication administration. In short, vendors get the freedom they need to explore new avenues, but the FDA doesn’t cede total control and retains an option that can be interpreted broadly enough to intervene when needed. In this sense, the MEDTECH act finds a middle ground using a risk-based approach to focus oversight where it’s needed most.

Key players in the industry have supported the bill; Health IT Now and the American Medical Informatics Association (AMIA) both praised the passage of the act, while major vendors including Athenahealth, IBM, and McKesson strongly supported the push to pass the bill. Undoubtedly, the passing of the MEDTECH act was great news for vendors.

The benefits to patients and vendors are clear, but what about healthcare providers and administrators?

CIOs and CMIOs already have their hands full in keeping pace with a seemingly endless set of transformations in health IT. Now the senate is aiming to quicken innovation and promote shorter times for technology to reach the market, inevitably resulting in a faster rate at which organizations must adopt that technology. Some providers likely viewed the passage of the act with an exasperated palm to the face. The frustration is real; the move to ICD-10 occurred less than seven months ago, not to mention many organizations have implemented EHRs but are focusing on optimization to improve their ROI.

Simply put, there is no end in sight to new technologies arriving in healthcare, and there will not be a slowdown anytime soon. Healthcare organizations must proactively plan a long-term adoption strategy that accounts for continual enhancements in technology, with a focused ability to quickly bring staff to a high level of proficiency. Those that achieve such agility will be able to leverage the best technology to offer the highest standards of care.

Xerox is a sponsor of the Breakaway Thinking series of blog posts. The Breakaway Group is a leader in EHR and Health IT training.