High-Tech Nightmare
Joseph Heaton, MD, a hospitalist with Kaiser Permanente practicing at Exempla Good Samaritan Medical Center in Lafayette, Colo., has spent the past three years helping develop an electronic medical record for the hospital.
The project includes computerized physician order entry (CPOE), which was rolled out Oct. 2. He estimates he has dedicated anywhere from 20% to 50% of his time to technology implementation.
“I’ve been the physician champion for the project, working alongside the IT (information technology) development team,” Dr. Heaton explains. “I was chosen not for any particular computer expertise but because of other leadership roles I have played as a hospitalist and my involvement in quality projects. I see CPOE and electronic medical records as obvious extensions of the other quality projects hospitalists participate in.”
Dr. Heaton’s experience in implementing a CPOE system highlights the barriers faced by those charged with advancing technology critical to hospital medicine.
He says he has learned a lot about computers along the way, but the technology is a snap compared with the challenges of managing change and making sure physicians are in tune with the new system.
“Not only was I representing other hospitalists, but also a broader group of physicians with privileges at the hospital, as well as other employees, including nurses and pharmacists,” he says. “Much of what I did was to translate language about workflow from the clinicians to IT, and then report back to the clinicians.”
But it wasn’t as easy at it sounds.
“Unfortunately, in this institution there is no single, agreed-upon communications venue for reaching all of the physicians who practice at the hospital,” says Dr. Heaton. “So we’ve had to use e-mail, voice mail, noon bag-lunch demos, mailings, departmental meetings and classes—multiple opportunities to make sure that physicians feel informed. That way, when they show up for their actual training in how to use the system, they’re not still asking questions like, ‘Why are we doing this?’ ”
