Communications with physicians and other providers

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Communications with physicians and other providers

The acceptance and engagement of physicians and other providers is critical. Not only can their lack of acceptance cripple an implementation, but their active involvement is needed to ensure that the guidelines and standard order sets meet local conditions and values. Effective communications are key to physician involvement.

Communications theory describes communications messages in terms of both the content and the channel. The content should be based on the needs and values of the providers, describing the benefits and also the upcoming challenges with the implementation. It should both demonstrate a commitment by the leadership team to the process while at the same time reassuring the physicians that they remain in control of their practices, and that they will get the help they need to succeed. The content should address both the rational and emotive responses to the implementation. Branding, creating a theme or logo, can do both by summarizing the value proposition for the physician/provider community.

A channel is a medium used to convey the message, e.g. an email, a meeting, or a tchoke (a tchoke is a giveaway like a pen with the brand logo for the implementation). One crucial channel that is often overlooked is a feedback channel – how will the implementation get feedback from the provider community both early and often? Channels need to be matched to the messages. A message designed to boost awareness (e,g, CPOE is coming!) can use a relatively sparse channel like a banner or a tchotke. On the other hand, richer channels (face to face meetings, video) are needed to address more complex issues, e.g. provider self-efficacy and autonomy. Because not all providers respond equally to all channels, repetition in different channels is important – say it three times in three different ways.

The best communications program will not save a flawed implementation. It will, however, be a significant factor in the early detection of problems and the successful implementation of most successful health informatics projects.

References 1. Ash J: Organizational factors that influence information technology diffusion in academic health sciences centers. J Am Med Inform Assoc 1997, 4:102-111 2. Young M, Post J: Managing to communicate, communicating to manage : how leading companies communicate with employees. Organizational Dynamics 1993:31-43 3. Dutton J, Ashford S: Moves that Matter : Issue Selling and Organizational Change. Academy of Management Journal 2001, 44:716-736 4. Stablein D, Welebob E, Johnson E, Metzger J, Burgess R, Classen DC: Understanding hospital readiness for computerized physician order entry. Jt Comm J Qual Saf 2003, 29:336-344 5. Ash JS, Anderson NR, Tarczy-Hornoch P: People and organizational issues in research systems implementation. J Am Med Inform Assoc 2008, 15:283-289 6. Lindenauer PK, Ling D, Pekow PS, Crawford A, Naglieri-Prescod D, Hoople N, Fitzgerald J, Benjamin EM: Physician characteristics, attitudes, and use of computerized order entry. J Hosp Med 2006, 1:221-230 7. Barron WM, Reed RL, Forsythe S, Hecht D, Glen J, Murphy B, Lach R, Flores S, Tu J, Concklin M: Implementing computerized provider order entry with an existing clinical information system. Jt Comm J Qual Patient Saf 2006, 32:506-516

Submitted by Dian Chase