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Computerworld - When CIO John Hummel tried to computerize the way doctors write prescriptions for patients at Sutter Health, a network of 26 California hospitals, he came smack up against an immovable obstacle: physician resistance.
"We tried to implement computer physician order entry four or five different ways," says Hummel. "We tried four different vendors. We tried PCs, tablets and PDAs." In every case, technology slowed the process for the physicians. A prescription that took five seconds to order on paper took two to three minutes on the system. The doctors were frustrated over the crippling effect on their productivity, Hummel says.
The result: "Even with the [improved] system we finally implemented, it takes about a year for a physician to recover to 90% of their original productivity," he explains, and less than 20% of the doctors use it. "I would have to label the attempt a resounding failure."
User resistance is nothing new in IT projects, but in a hospital setting, the stakes are higher, and life-saving projects can be doomed by recalcitrant doctors. Still, user opposition is justified if new safety systems steal precious time and disrupt workflow.
The best way to win doctors over is to follow the same rules that guide any good IT system implementation: Start with strong executive support and realistic expectations; understand your processes and how the system will affect them; anchor the system with an efficient, bug-free back end; build a user-friendly front end; find committed users to lure in the rest; and provide good technical support. But most important, understand what really motivates your users.
Failed Front Ends
Hospital safety systems are doomed to fail if the physician-facing front end isn't tied to an efficient and responsive back end, and the back end needs to be built first, says Chris Giglio, director of the Accelerated Solutions Center at Cerner Corp., a Kansas City, Mo.-based vendor of hospital automation systems. "The physician changes should be implemented last," he says. The system must have a flawless workflow before it's put in physicians' hands so that the effect on them is minimized.

Image Credit: Gary Swift

Jayashree Raman, CIO at The Reading Hospital and Medical Center in Pennsylvania, is following that order. Last year, she installed a back-end medication administration records (MAR) system, which enables clinicians to match a patient's bar code to the bar code on a prescription drug before it's administered. "The MAR is designed to ensure the five rights: right patient, right drug, right time, right dosage, right route," Raman explains.
She also plans