Health Care's Digital Transformation: The Critical Role of the Clinician

Global momentum is quickly building for the widespread adoption of electronic health records and related information technology to improve health care quality, safety and operating efficiencies. Support for this digital health care movement has taken hold in many parts of the world.

For clinical IT to fulfill its potential of helping to transform health care, an understanding of success factors is critical. To that end, Accenture collaborated with the Vanderbilt Center for Better Health to identify the critical success factors for clinical IT adoption. The study suggests a number of key strategies that appear to significantly affect the adoption of new technologies by clinicians, such as the use of electronic health records (EHR) and other digital health care transformations.

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Vanderbilt researchers interviewed nearly 50 executives and clinicians at 22 hospitals and health systems in five countries that have implemented clinical IT systems—electronic health records, computerized provider order entry and clinical decision support—across some or all of their institutions. The primary research was supplemented with the examination of 75 articles, white papers, case studies and other materials.

Perhaps the most important finding is that physician engagement and support is a critical variable in the overall success of an IT implementation. Regardless of the physician's relationship with the institution, leaders of the implementation effort need to gain the understanding, support and involvement of the physician community to be successful.

The research revealed that the time and effort involved in doing this well can be a deterrent to doing it at all. Experience suggests however that careful groundwork and a slow start are preferable to the failure of a project one year down the road.

Seven critical success factors for implementing clinical IT projects emerged from the research:

1. Alignment of clinical and executive leadership—a common vision with agreed goals and expected results.
   
   
2. Effective early engagement of clinicians—during the planning phase as well as throughout the project.
   
   
3. Recognition of the unique relationship between physicians and the institution—as the face of the medical institution and major bearers of the burden of IT adoption.
   
   
4. Unwavering commitment to success—from the organization's leaders who must emphasize the strategic imperative of the project.
   
   
5. Deployment to new places when the benefits are clear to clinicians—gain a critical mass of support and only move ahead when there is agreement that implementation would be a win for all parties.
   
   
6. Individualized approaches to training and support—to fit in with clinicians pressured schedules.
   
   
7. Tight feedback and enhancement cycles—to gather input after the initial rollout and enhance the technology based on the experiences of early adopters.

The research identified seven critical success factors. The more of these critical success factors that a health care institution can incorporate into a large-scale technology implementation, the more likely it will be to drive adoption and produce better outcomes for clinicians and patients.

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