Technology offers promise for those looking to solve logistical problems in medicine, improve EHR usability and support physicians and other health professionals by enabling their ability to care for patients. Changing technology is a process that includes many vital, yet decidedly unglamorous, steps, according to experts in clinical informatics.
Margaret Lozovatsky, MD, vice president of digital health innovations at the AMA, recently shared five important considerations—among them establishing a governance model and agreeing on shared priorities—in designing technology to support clinical practice. Dr. Lozovatsky’s presentation was part of a two-day AMA training event to help physicians eliminate unnecessary work and free up more time to focus on what matters most—patient care.
“Understanding the pain points of clinicians and creating a collaborative governance structure to address them is critical to drive best practices and continuous improvement when implementing clinical technology,” said Dr. Lozovatsky. “If you don’t have that foundational process in place, it can lead to poor experiences with clinical technology and challenges incorporating new, innovative tools into practice.”
Effectively integrating technology solutions into medicine will be a critical part to addressing widespread physician burnout—a phenomenon that thoughtful technology integration can address.
Though fewer physicians are reporting symptoms of burnout than they did during the height of the COVID-19 public health emergency, too many continue to suffer. The implications for the physicians themselves, the organizations that employ them and patient care are manifold.
As the leader in physician well-being, the AMA is reducing physician burnout by removing administrative burdens and providing real-world solutions to help doctors rediscover the Joy in Medicine™.
Here are five key takeaways from Dr. Lozovatsky’s recommendations.
Understand the current state
Change will not happen overnight, and it’s better to make the right changes over time than it is to make the wrong changes quickly.
Before any changes can be conceived of—let alone made—understand the needs and the unique character of the organization where the technology will be used. That means asking: Who uses the technology and for what purpose? What are the organization’s goals and priorities? What do we need to establish a baseline to measure future impact?
There also should be a road map for the process of demand management. The questions to ask include:
- How do requests come in?
- Who is putting those requests in?
- How do requests get prioritized?
- How do they get approved?
- How does it work through the process of making the change?
- Who is reviewing the changes?
- How are you doing the actual change management?
- What is the feedback mechanism to stakeholders?
- How are you managing adoption/end user education?
Asking these questions about the current state and what exists today will help guide how organizations evolve their processes.
From AI implementation to EHR adoption and usability, the AMA is fighting to make technology work for physicians, ensuring that it is an asset to doctors—not a burden.
Establish guiding principles
Once it’s clear where the organization is, the next step is coming to a shared understanding of what the priorities and goals will be for technology projects or changes. One place where organizations often disagree is on the level of standardization allowed—for example, will pediatrics and cardiology have the same solution?
Organizations need to develop a set of high-level guiding principles to define rules and ensure consistency across departments and projects.
When it comes to goals, it’s crucial when examining a project to first determine what problem the technology is targeting and to examine whether that’s the best way to achieve that aim. For example, a common challenge that physicians and other health professionals experience is the management of home glucose measurements, which often come from patients in different formats such as thumb drives or spreadsheets. Many technologies have been developed in an effort to address this challenge, however many do not integrate into existing technology systems and hence do not simplify the current process and often add to clinician burden.
Many of these new solutions sound great, but often come with a significant cost, and they are not actually integrated as well as they tell you. Having guiding principles in place for how your organization handles new technology projects helps mitigate excitement over potential and puts the focus on what will work for clinicians. Understanding the clinical challenges and partnering with the technology teams to find solutions that address the problem and integrate seamlessly into the clinical workflow is a critical aspect of successful technology implementations.
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Create a governance model
Establishing both a governance model and a true partnership between IT and clinical operations is also essential.
In a governance model, participants and stakeholders know their roles and responsibilities, which helps not only in the process of determining which changes to make but also in enacting those changes. Without these pre-determined levels of participation, confusion can reign, and stakeholders can end up decidedly outside of their lanes.
Another important aspect of governance includes creating a prioritization process for projects and changes. There's always more work than there are resources to do the work, so having a clear, transparent way of approaching this sets an organization up for success.
Another key is having physicians who specialize in clinical informatics, who can function as a liaison between clinical operations and IT. “I often use the analogy that it's like a translator for two different languages,” Dr. Lozovatsky said. “They live in different worlds. They have different priorities, and clinical informatics can bridge that gap.”
Find ways to communicate
It’s no mystery that physicians have packed schedules, ones that rarely can accommodate a barrage of corporate emails or lengthy meetings. But they do need to be updated and want the communication to come in real time when they need it
Creating local “experts” with extra training who physicians can seek out if they have questions can be helpful. Communications should also come from someone who the physician knows and trusts as opposed to a remote corporate figure. Multiple channels of communication should be used, she said, and updates should be sent on a regular cadence.
Physicians want to have a voice in the conversation, and while not everything they ask for will happen, they definitely appreciate a feedback loop.
Be flexible, and stick with it
It’s important to understand that the process of making technology changes is a long one, with many twists and turns. Processes will break down. Priorities may need to be revamped. And adaptation is key. Having a continuous improvement mindset when implementing technology ensures that systems evolve to meet the changing needs of healthcare professionals and patients.
For additional ideas and tools for practice innovation, check out the AMA STEPS Forward® “Saving Time: Practice Innovation Boot Camp,” March 31–April 1 at the Association’s Chicago headquarters. The conference will cover topics including debunking regulatory myths, reducing barriers to taking paid time off, optimizing the EHR inbox and more. Learn more and register now.
For more information on implementing AI in your practice, check out the AMA STEPS Forward® virtual learning collaborative on AI Governance that launches April 17. Learn more and apply now.
