Ten steps to great information technology (IT) implementation

To successfully implement information technology (IT), hospitals must do much more than install hardware and software that automates existing paper-driven processes. Hospitals should remember that because physicians are the key end-users of any IT system, they need to be at the table for the selection, design, and implementation. However, physicians may not always be willing to volunteer for IT efforts when there are so many other demands for their time and energy.

The following is a 10-step solution to engaging physicians into an IT implementation project. These steps are modeled after the principles enumerated in Leading Change by John P. Kotter, published by Harvard Business Press, 1996:

Step 1: Establish a sense of urgency. Hospitals in the future will need to implement technology systems that address public accountability, transparency, and outcomes-based payment systems. By educating physicians on technological developments, hospitals can make a strategic case for IT development as a competitive strategy.

Step 2: Appoint a medical informatics technology task force. The task force should consist of physicians, clinical and non-clinical staff, technical staff, and administrators who have enough authority and leadership training to champion change.  The key is to tap the intellectual capacity of end-users to ensure the right selection, design, and implementation of various IT components.

Step 3: Develop a vision and strategy for getting there. Develop a vision, and work backward from there to determine what steps you need to take to achieve that vision. Ultimately, the hospital’s goal should be to redesign care processes to create greater efficiencies at the bedside. Failure to redesign clinical processes in conjunction with IT processes could result in more work because of the added complexity of the IT system.

Step 4: Communicate the vision.  Some people are early adopters of new technology, some will never change, and some are always “on the fence,” waiting to see how things go. Hospitals need to aim the communication of their vision to those who are on the fence. When communicating with physicians, hospitals should take care to address the question that is foremost in physicians’ minds: What’s in it for me? All 10 steps outlined here are important, but this step is critical to the ultimate success or failure of IT implementation.

Step 5: Solicit physician input. A best practice is to establish an internal beta site that allows the medical staff to pilot test new technology. Provide medical staff members with a clear process for providing feedback and IT and administrative personnel a clear path for making the necessary corrections.

Step 6: Identify resources for current and future versions. When developing a strategy and vision (step 3), be sure to identify the people and resources needed to solve specific problems. Most organizations will discover that they require many more resources to accomplish process redesign than initially believed, so anticipate it and plan for it. 

Step 7: Secure medical staff approval. The medical executive committee (MEC) should approve and endorse the approach recommended by the IT implementation task force. Without the full support of the MEC, the rest of the medical staff is less likely to jump on board

Step 8: Educate physicians on the use of the technology. Once the appropriate technology systems are in place, the hospitals should provide on-site training for medical staff members. Ensure that adequate personnel are available to conduct the training. Ideally, these personnel will not be “techies” who may use language that confuses or intimidates “non-techies.” To achieve this, hospitals may want to consider developing a train-the trainer program under the auspices of a Chief Medical Informatics Officer (CMIO, usually a physician) or the Physicians Relations Department. The CMIO position is in and of itself a best practice. 

Step 9: Use initial gains to fuel further change. Once the medical staff realizes the initial success of an IT implementation project, it often fuels their desire to update and upgrade other systems, structures, processes, and policies. 

Step 10: Create a living process. Acknowledge that the work is never done, but rather involves a constant improvement feedback loop to help design and implement the next version.

Implementing an IT project can be a daunting and seemingly impossible challenge. This step-by-step process offers a practical framework for overcoming road blocks and getting your facility on track to success. 

Until next time, be the best that you can be.

William K. Cors, MD, MMM, CMSL, is the vice president of The Greeley Company, a division of HCPro, Inc. in Marblehead, MA.