By Susam Vang, Hayes Management Consulting
Twitter: @HayesManagement
If implementing an electronic health record (EHR) is not already challenging for most healthcare organizations, an EHR system design and implementation’s success or failure is greatly dependent on its stakeholders and subject matter experts (SMEs). A SME is an expert in a particular area or topic. They are the primary intended users – people who will be making decisions on the basis of the workflow analysis, system design, and are a key group of stakeholders. SMEs are important to not only assisting in the system’s development and implementation but also in maintaining the long-term use and effectiveness of the system within an organization.
Striking a balance between the information technology (IT) department and departmental autonomy may be even more of a challenge. Even more so is to effectively augment and involve SMEs, all while keeping everyone happy. The challenge may turn out to be a very difficult one if your SMEs prove to be resistant to change. Based on my past experiences, I have written down four ways to win over SMEs in order to implement an EHR project successfully.
- Be accommodating and easy to work with
- Understand and engage your SMEs from the beginning
- Create success stories to generate influence
- Constant communication
Be accommodating and easy to work with
Everyone likes to work with someone who is nice and easy to get along with. By being pleasant and patient, you can melt down most of your SMEs who are defensive about the project. Keep in mind that SMEs are not being difficult just for the sake of it; they probably feel something about the project is not most effective for their area of expertise. Therefore, it is important you listen to their reservations and fix them wherever possible.
I was a lead clinical systems analyst coordinating a project of launching a new clinical tool and one of the SMEs, who was one of the key influencers, did not like the new system since he thought it was not at all user-friendly. He complained about the system and how he will be doing more computer work than taking care of his patients. Whenever he attended clinical content design sessions, he would complain that he went to medical school to take care of patients, not to do computer work. At each session, I always acknowledged the genuine limitations of the system and asked for his suggestions to improve it. The result was that over a period of time he calmed down and agreed to test the new tool and give his feedback. He later became a champion in using the system and offered tips and tricks to his peers.
Understand and engage your SMEs from the beginning
Understanding and taking into account the priorities and concerns of different SMEs from the beginning of a project will help with communication strategies during and after the design sessions. Different SMEs can be engaged for different purposes and at different phases of the system design sessions and implementation planning. Involving SMEs at the beginning of your project can add value by:
- Providing perspectives on workflows that may have been initially overlooked or missed
- Contributing an understanding of the department’s business or clinical workflow requirements
- Helping to make sense of workflows, gaps, and how the department and or specialty will use the system
- Participating with IT staff and vendor representatives in discussions involving the implementation of a system and or application changes that may have an impact on the department’s workflow, productivity, or end-user’s functionality
- Serving as the department’s liaison to the IT department to facilitate basic troubleshooting, problem identification, and escalation to the technical experts or the vendor
- Acting as primary contact to whom the IT department can communicate technical issues or outages that impact the department’s productivity or ability to provide services
- Increasing the use of the new system by building knowledge about and getting support for the project objectives
Create success stories to generate influence
Choosing your initial go-live site is one of the most important decisions in your implementation plan and getting SMEs to adapt to a new change can be very difficult. Identify which SMEs are more adaptable and target them accordingly. Some SMEs can be easier to work with than others since they either have more adaptable personalities, are more flexible, and or their demands are not very stringent. Seek out these SMEs first for piloting or rolling out a new project. They may be easier to embrace and adapt to change. The selected SMEs will work with your project team to make the system as useful as possible and create a positive impression of the system for their peers and the rest of your organization.
Success stories from these SMEs will go a long way in convincing some of the other more obstinate users from other departments to be far more open to the change. SMEs at these sites are also more likely to champion the benefits of the system, potentially reducing negative attitudes in other departments.
Constant communication
End-users can get very stubborn when a project’s deliverables do not meet their needs and may not agree to use the software at all. This could happen due to communication gap between them and the upper management. Thus, SMEs must be kept in the loop constantly since the project is for them and they must be made to feel as if they are a part of the project team. Often times due to budget constraints, you may not be able to meet every demands of your SMEs. A tight budget may not allow the project team to solve an issue, even when upper management also knows the issue needs to be fixed. The SMEs must be made aware of such situations and must know why a particular request of theirs is not being delivered.
The unwillingness to adapt may not lessen but at least they will be more open to discussing alternative solutions. Therefore, communicating why a request is not being met due to a genuine reason and not due to negligence, will lessen the friction. Actions must also follow words since most serious and genuine issues must be solved in order for the project to be successful.
End-users will always be hesitant towards a change since it is a “change” and they have got used to their comfort zones. By taking into account the end-user’s views, listening to their complaints carefully, sympathizing with their situation, gaining the trust of these people, and convincing them to adapt to the change by being on their side – not just someone upper management has sent to force them to adapt to the new system. If such trust could be gained, then even if the system may not meet some of their needs, they will still agree to use it.
This article was originally published on Hayes Management Consulting and is republished here with permission.