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6/21/2004
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Other Voices: Getting Physicians To Use IT--A Success Story

How Genesys Health System got 80% of its physicians to participate in a digital-document-management system, and is saving $1.9 million annually.

The Hippocratic Oath doesn't mention business technology, but then again, it was written 2,400 years ago. Were it rewritten in the 21st century, it could be argued that physicians should pledge to use business technology that makes health care more effective and affordable.

Life increasingly demands that people be able to understand and use information technology and, not unexpectedly, health-care consumers expect their doctor to exhibit similar familiarity. What's more, they want information technology to improve care and cut costs.

Hospitals are responding to this pressure. Many are investing in information technology to enhance care through improved productivity, streamlined operations and administration, and increased control and insight into patient data. In fact, Gartner Dataquest issued a report (In Unforgiving Times, the U.S. Healthcare Market Boosts IT Spending, 2001-2006, Aug. 12, 2003, by Geraldine Cruz) in which it predicted that the health-care IT market would experience 7% compounded annual growth at least through 2006, when it's expected to reach $47.9 billion.

While I'm not at liberty to say how much we're spending on IT at Genesys Health System, I can say that our move to a digital document-management system created a one-time savings of $250,000 when it went live 18 months ago and is expected to save $1.9 million annually.

We did away with paper medical charts and moved to generating charts digitally. Now, charts and documents from multiple departments are available in one place, which eliminates lost or illegible files and puts critical patient information in physicians' hands faster. As many as 100,000 documents a month--including digital captures of handwriting, X-rays, and other charted data--are available online.

Selling this change to the money people was one thing; convincing our physicians to accept and use the system was another. Yet, today our doctors more quickly respond to changing patient needs with appropriate treatment, counsel, or hospital release. About 80% of physicians are participating. Many of them are even making drug recommendations from home online as well as over the phone, allowing patients to get their medication several hours sooner. This means faster recoveries and shorter stays for some patients.

We started from the premise that physicians generally aren't trained in business operations, much less business technology. Tell a group of physicians that they now have a central data repository from which to access charts at all times and watch how many sneak a peek at their pagers. Many of them already think they have that access--they call it a nurse, an office manager, or a hospital administrator. Tell them that they have to embrace business technology to deliver the highest value to patients and you might hear outright snarls.

The truth is that society pays deference to talented doctors, and most doctors feel--rightly--that they reached this position of respect using their brains and hands, not a keyboard or stylus. But health care now is a highly competitive, regulated, and complex business. The most-successful patient outcomes will be the result of an interdependent relationship between the medical care and business technology.

Steps To Rollout
The trick to a successful rollout is anticipating resistance and addressing concerns early.

  • I recommend clearly communicating how a new system helps with what's important to physicians and organization alike--the patient. For example, faster and more comprehensive delivery of patient data makes faster and more-accurate diagnoses possible. Back that up with empirical data and the physician is likely to respond positively.
  • Provide the physicians with the right training. The system might be generic, but the training needs to specifically relate to the physician's area of specialty. Target the diverse pockets of users in your organization, some of whom are early adopters and some of whom are not. Customize your message to minimize each group's anxiety. At Genesys, cardiologists are the most computer savvy so they're often the ones who lead the adoption and have enabled us to gain support from other groups of physicians.
  • Because physicians often have preferences on what types of devices they like to use, support multiple devices--from standard PCs to wireless devices on carts. In emergency rooms, doctors like to use wireless tablets for quick access, whereas in the critical-care areas, doctors prefer to use hardwired desktop computers positioned next to the patient's bed.
  • Ensure that the presentation of data works well with the different job requirements of the users. At Genesys, members of the IT staff went on rounds with 30 physicians to get a sense of their workflow. We then built customized workflow screens on the front end of the systems based on the physicians' needs.
  • Technology has clearly emerged as an important tool in the transformation of the health-care industry, but it is innovative business processes that will be the true driver. I always say that, at the end of the day, it isn't an IT project, it's a business project with an IT aspect. Our real challenge is to bring business discipline to our industry and to continue to tap into technology to further our goal of improving patient care.

    Dave Holland has more than 25 years of management experience in information technology and has been the VP and CIO at Genesys Health System since 2000. Genesys Regional Medical Center is a 410-bed hospital in mid-Michigan. He spent more than 13 years working at Citicorp, where he specialized in managing implementations, conversions, and system migrations. He has worked with marketing firms, large manufacturers, and large utilities prior to spending five years in higher education, where he served as CIO for a large community college in Michigan. He holds a bachelor's degree in Information System Management from Cleary University. He can be reached at dholland@genesys.org.


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