(Healthcare IT Podcast) EHR Implementation: Thoughts on the Role of Leadership ft. Kelly Dungee

Posted by The HCI Group on November 14, 2016 at 7:57 AM

Healthcare IT Podcast

For the seventh episode of our Monday Morning Healthcare IT Podcast Series, Tom sits down with industry leader Kelly Dungee, who has experience as an AVP, CIO, and as registered nurse. Tom and Kelly will be discussing the role of leadership during an EHR Implementation, focusing on areas such as champions, organizational vision, and handling change.

In case you missed it, make sure to check out our episode from last week, where John McDaniel discussed the future of healthcare, and how innovation will play a large role in shaping the way healthcare will look by the year 2025. Additionally, make sure to see what Kelly had to say about the who, what, and why of governance structures with regards to EHR implementations.

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Hello and welcome, everyone. My name is Tom Letro of the HCI group, and today we will be sitting down with Kelly Dungee, who has experience as an AVP, CIO, and as a registered nurse.

Kelly is an HIT and EMR leader who aims to help healthcare organizations and clinicians positively transform patient care with technology.

Today, Kelly and I will be going over the role of leadership, with emphasis on things like champions, having a vision, and dealing with change. Thank you for joining us Kelly.


Good morning, thank you for having me.

Organizational Leadership and Implementations


Thank you for being here! But Kelly, when it comes to implementation, the effort has to start at the top, with leadership. How can organization leaders help in a successful implementation?


I think successful IT implementations of all kind, whether they be EMRs, whether they be clinical information systems, departmentally, large implementation efforts around supply chain, they really all have to start with a top level executive commitment, and that commitment really needs to come from the board and the C-Suite, and they need to make the effort a true organizational priority. There will always be competing priorities within organizations, but when the rank and file sees the leadership consistently sort of fall to the side of the implementation, that really sends a clear message, that this is an organizational priority, and effort that everyone needs to get behind.


And what specific members of leadership need to take charge here?


Really, clinical obviously champions or business champions, depending on the type of system that is being implemented, those operational folks really need to be visible, they need to be engaged, and they need to be accountable for the success of the effort. Those folks really need to be named, so the CMIO, the COO, the chair of the department of radiology, they need to be named as leaders in the effort, and then whatever department or, you know, again, whatever piece of the organization, those folks have to be identified as the champion of the project, and that is a really important word to use. And again, it puts back that organizational commitment effort.

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Champion of the Project


And what does it mean to be the champion of the project?


Yeah, the champion of the project is really the person that’s ultimately accountable, ultimately responsible, is, forgive the expression, the cheerleader for the project. Is able to elucidate the benefits, the why folks are going through this incredibly disruptive effort, and needs to be consistent in their message about why this is happening, and what benefit it is going to bring to the organization, to the department, and to the individual end user. And they need to get really clear about that.


Ok, and with that in mind, who should be considered the champion of the project?Is there anyone that you think specifically should be kept in mind?


I think one of the most important things is that any technology initiative not be seen as an IT project. Often, you’ll see the CIO as the champion of the project. Of course, they’re a very important stakeholder, but projects really, to see them become successful, they need to have that departmental, that organizational leadership. So, your Chief Medical Officer, Chief Nursing Officer, again, Chair Department of Radiology, Chair of Rev Cycle, if you’re doing a revenue cycle project. Those are the folks that need to be the champions, the technology is there to support the operations, and further their goals.

Improved Patient Care


And I’m going to re-emphasize one thing you said right there Kelly, because I think it is very important to remember, and that is that projects such as these are not just IT projects. 

For those of you listening, you can probably recall my conversation with David Chou in which we went over how these technology initiatives are organizational projects, and should be treated as such, because, after all, the end goal isn’t simply installing a new software, it is better care for our patients, right Kelly?


Absolutely, and I think that really kind of goes to vision, right? I think the champion, I mean the IT organization, the IT department in the organization, is really there to further that vision, and keeping that patient in mind is really what’s most important. These are projects that for, whatever the end goal is, are there to better the health, improve the movement of the patient through the organization, so I think that’s why it’s so important to name champions that are part of the operational leadership of the organization.

Vision Behind the Implementation


Ok, so in regards to vision, what must be made clear when undergoing a new implementation, is there anything you need to really lay the groundwork for?


And I touched on that a little bit back in the leadership discussion, I think getting really clear on the why we’re doing this, and being able to tailor the message to the receiver, so when you’re undergoing an EMR implementation for the CFO, the CFO wants to know that, he wants to understand the why around his billing, right? Making sure that HIM and medical records stay intact, that they aren’t able to not code. So his message is going to be very different about the why than would be a floor nurse who has never used an electronic medical record to care for her patient at the bedside.

So, the why, the vision, has to be broad, and suitable to a lot of different audiences, and also has to really clearly demonstrate that benefit to the organization and to the patient. Those benefits have to be clearly defined, again, tailored to the user, and they have to be measurable. One of the things that I think organizations often forget is that they forget that needs to be communicated over and over and over again. It is not a single governance meeting where we go ‘okay, we’re going to do this to reduce AR days, to increase our patient satisfaction scores, to better on our HCAT scores,’ those benefits need to continue to be communicated over and over and over again. Lots of studies show that you have to read things four or five times or more to begin to really integrate them, and so those benefits have to be communicated frequently and throughout the course of the project. Again, for vision, the most important thing, again, they all have to tie back to the patient in some fashion.

Culture Change


Right, because, again, better patient care ultimately is our end goal.

But with the implementation of a new system coming in there is obviously going to be a lot of change, how does the culture of your organization change during a new implementation?


Well, radically usually. I liken EMR implementations to sort of having your first child. You think you know what it’s going to be like, and you’ve gotten advice from mom and dad and other folks who have done it. But until you do it, you can’t really know what it’s like. They are radical changes in an organizational culture, be it the EMR or really any informational system into a spot where there was none before. The leadership has to be really flexible and prepare and support and foster that culture of change throughout the organization. Again, communication, recognizing that this is difficult, recognizing that this thing is taking time away from your patients.

Resistance to Change


Ok, and is it common to see any resistance to this change? If so, how should leaders react to this resistance?


There will be resistance, and there will be folks who refuse to adopt. I think leadership has to really show a commitment to helping get those folks over the hump, and, unfortunately, if they can’t get them over the hump, [they] figure out how they move them around the hump. The organization really has to show true commitment to the implementation. If there is a heavy rainmaker, cardiothoracic surgeon, who just absolutely refuses to get on board, and is just very upset and angry about how this has changed his or her practice, organization leadership and those champions have to work with that person to move them forward, and again, if they cannot, they have to figure out how to move them out.


And you hope it never has to come down to that, but at the end of the day the role of the leader is to make sure that everything is being done for the better of the organization, although it is not always an easy task. But thank you Kelly that is all the time we have here today.

For more information on the role of leaders during an EHR implementation, make sure to follow us on social media, and to subscribe to our blog and our podcast. Also, make sure to comment with anything that you think is equally important or that we may have missed, so that we can keep the conversation going.

For Kelly Dungee, this has been Tom Letro of the HCI Group. The HCI Group, offering a smarter approach to healthcare IT.

Topics: EHR Implementation, Podcast Series

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