Do not involve Clinicians at your peril


This post from e-Health insider cites a recent study from Kaiser Permanente on the implementation from a new EMR. THe main findings were as follows

• Users perceived the decision to adopt the EMR as flawed;
• Software design problems increased resistance;
• The system reduced doctors’ productivity, especially during initial implementation , which fuelled resistance;
• The system required clarification of roles and responsibilities which was traumatic for some individuals;
• A cooperative culture created trade offs at various times in the implementation;
• No single leadership style was optimal – a consensus building may
lead to m ore effective adoption decisions, whereas decisive leadership
could help resolve barriers and resistance during implementation;
• The process fostered a counter climate of conflict which was resolved by the withdrawal of the initial system.

I doubt if there has ever been a software project that has succeeded where the ultimate users have not been involved. And involvement clearly means more than token participation in say a user group.

I would regard 6 of the 7 points above as being pretty standard, but the first point – the recognition of the introduction of the EMR as being "flawed" – this is worrying. This shows their is never a point that should be too early to involve the clinicians or users – you need to bring them along in the process.


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