Often healthcare IT leaders and teams find a chasm in expectations and understanding when it comes to implementing and optimizing technology for the physician community. In an interview on The CereCore Podcast, Dr. Charles Bell, physician advisor for CereCore, shares advice from his experience working with physicians and IT teams during technology change and adoption. Prior to joining CereCore, he was a vice president of advanced clinical applications for HCA Healthcare, and he served as a physician champion for MEDITECH 6, Epic, and Cerner.
Dr. Bell began his healthcare career working as a pharmacist and hospitalist in intensive care and critical care where he saw firsthand the advantages of using technology to help deliver efficient and effective care. This experience led to him becoming an early adopter of handhelds and EHRs.
In this podcast interview, Dr. Bell paints a clear picture of the challenges physicians face adapting to new technologies while under pressure to find information quickly and provide timely care. Drawing from his bedside experience, Dr. Bell shares practical ways IT teams and physicians can have a better understanding of technology needs and clinical workflow. This collaboration harnesses the power of EHR technology and fuels ongoing optimization.
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How to improve IT and physician collaboration for the betterment of patient care
From the early days of meaningful use to post-pandemic, healthcare organizations and caregivers recognize that an EMR is a must-have, but tension and challenges can still exist and have a ripple effect to patient care. The system needs to work for everyone. Dr. Bell says collaboration during physician advisory councils and group meetings among physicians and IT during the build phase is critical.
As a liaison, Dr. Bell has had many conversations with physicians during the throes of an implementation. “What I enjoyed the most about what I did, and what I continue to do, is understanding both sides,” said Dr. Bell.
"There is this attitude a lot — and I'm saying this as a physician — that we ‘got this’.”
“You are going to have trouble. You are going to have difficulty making that transition if you do not put some work into it to begin with.”
“What helps IT is if you started that build phase and you do a day in the life. You walk through what my process is and learn how to answer: what is the process of a nephrologist? What does that process do to the surgeon? How did they get to the data that they need to get to? When you do that walk through, you can make that build so that you minimize the hangups. You basically close that gap. But the other part of closing that gap is really being able to understand what it is like to walk a mile in that other person's shoes.”
Often physicians and IT come at the same issue from two different worlds, mindsets, and backgrounds. Perhaps one of the first steps is to acknowledge the differences and respect the expertise each viewpoint brings to healthcare. Dr. Bell shared several best practices to encourage collaboration.
“The starting point is to understand one thing: we are all on the same team. That is the starting point,” said Dr. Bell.
"My role and my job are different, but without you, I can't get my job done. I am not saying that we are going to turn IT folks into physicians and vice versa. We are not trying to do that. But you have to have that understanding of what is involved.”
“I sat on a lot of councils throughout my time at HCA and with CereCore,” said Dr. Bell. “It is really interesting, because you can make a decision, and a year later you have turnover, and you get new people on that committee. They want it a very different way. And you really have to document and show the reason why you made that decision.”
So having that as the core then, first and foremost we are a team, and secondly, this is why this decision was made and having that historical aspect, that record and that track record of it really helps. But also understanding what the offense is doing and the defensive job is doing. Basically, as I said, you have to understand that you are on the same team.
When engaging with physicians and providing IT support, circumstances can have an effect on the tone of the conversation, but you have to focus on the important details — the nuggets that might lead you to understanding what the issue might be.
“You have to listen for the message,” said Dr. Bell. “They can be venting. I cannot take that personally. And that is the part that is difficult, because we do not like people screaming at us and we do not like people being upset with us.”
"They might not be able to tell you that there is a problem with single sign on. They may not be able to tell you that I left the session open somewhere. They may not be able to tell you any of that stuff, but, in essence, they will. For example, ‘I was on the other floor when I came down, I tried to log in and I had a problem.’”
Dr. Bell concluded, “That is the biggest aspect, I think — being able to figure out all of the noise and really hone in on what they are complaining about.”
Building relationships between IT and physicians or clinician community requires intentionality, respect and meaningful conversations, not only to complete a project successfully but to continue improvement.
“The whole point of the build is to get you to a point where the system is effective and useful,” said Dr. Bell. “So, you want to have multidisciplinary input. You want to have exposure for people to see what the system can do, a direct line of communication.”
“But keep in mind, go-live is like commencement. And it is called commencement for a reason. It is the beginning, right? So, when you look at the effective system, that system is nowhere near being used to its fullest extent.
"When you start looking at optimization, that does not mean you are bringing in new functionality, that means that you are capitalizing and utilizing the available functionality to its fullest.”
“It takes some investment of time by the individual, whoever that individual is. It takes an investment of time to customize and individualize that tool. And that's all it is. It is a tool to help them do what they have to do to care for the patient or whatever their duty is. I think the biggest part and challenge that I see, and I see it on both sides,” said Dr. Bell.
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