Dr. Jay Anders is Chief Medical Officer at Medicomp Systems
The clinical documentation improvement program at Phoenix Children’s Hospital is unarguably a success. Since starting the project about four years ago, Phoenix Children’s has virtually eliminated transcription in its outpatient clinics, saving the organization $1 million a year. In addition, physician productivity is up, the quality of documentation has improved, and clinicians now have better clinical information at the point of care.
Many factors have contributed to the positive outcomes, including solid technology, forward-thinking clinicians and a committed staff. However, if we had to identify one thing that made this project particularly special, it would have to be the high level of IT and clinician collaboration. We believe that if more organizations promoted strong partnerships between their IT professionals and clinical teams, success stories like ours would be the norm, rather than the exception.
Here’s a bit of background on our initiative. As Phoenix Children’s was rolling out EMR into its ambulatory clinics, clinicians indicated a desire for documentation tools that would enhance their productivity and facilitate the capture of data to track quality-related activities. Phoenix Children’s selected a clinical documentation tool from Medicomp that would work seamlessly with the existing outpatient EMR from Allscripts. Clinicians and the IT staff then worked together throughout the process to customize the system to address the needs of physician users. Two years after going live, the clinicians have created over half a million clinical documents – and far exceeded the original project goals.
The outstanding collaboration between IT and clinicians was vital. To break it down further, any organization seeking to meet or surpass their health IT implementation objectives should consider these three factors:
- Select the right tools. To monitor and enhance patient outcomes, Phoenix Children’s physicians needed customized documentation templates based not only on individual specialties, but also specific diseases within each pediatric specialty. For example, the rheumatologists required a highly customized template for juvenile idiopathic arthritis that allowed users to capture details on 71 individual joints, as well as other measures.
Phoenix Children’s would have been challenged create such a variety of customized templates if the organization didn’t have easily-adaptable tools. When selecting technology, consider both current and future needs and make sure the selected solution can be customized to address the unique requirements of your organization and individual users.
- Communicate continuously. Communication improves collaboration, which is why clinicians and IT staff must prioritize ongoing and continuous communication. Throughout the implementation, Phoenix Children’s physicians and IT leaders met regularly, both formally and informally, and discussed user needs, system capabilities, and ways to improve the documentation experience for all users.
Sometimes IT organizations have staff members who lack strong communication skills or feel intimidated by physicians. Work with these individuals and provide them with supportive training, as needed. Many-times physicians don’t want to “waste time” on tasks that don’t involve direct patient care. Help physicians understand that meeting and talking with IT staff will ultimately lead to desirable rewards, such as increased productivity and better documentation. Find a way to make strong communication part of the organization’s culture.
- Provide ongoing feedback. Physician and IT collaboration doesn’t end at the go-live. As users adjust to the new system, they may discover the need for additional refinements to optimize workflows or more easily capture data. Clinicians must articulate what they want, and IT staff must continuously ask what more can be done to enhance the tools – and then be open to investing additional time and energy to creatively address ever-evolving requirements.
Phoenix Children’s physicians regularly share feedback with the IT staff on their needs or offer suggestions for new features. Both groups remain committed to ongoing collaboration because they recognize that patients and their families are the ultimate beneficiaries of their efforts.
