Making Culture Your Ally in Clinical Information System Implementations

An organization's culture can make or break any Clinical Information System (CIS) implementation. Ask Joy Keeler, Chief Architect of Nicholas E. Davies Award-winning CIS initiative for University of Illinois Medical Center.

"We knew from the beginning one of our greatest challenges was overcoming a prevalent attitude of doubt within the organization as we moved to a paperless clinical information system. Once we showed quick wins and provided proof that we could make things better, we built a following among all the stakeholders at UIMC. By creating a passion for our mission, we transformed the way we deliver care, improving patient outcomes, reducing waste and variances, even improving our retention rate among physicians and nurses. And while everyone has embraced the new system, the principal beneficiaries are our patients," said UIMC's current Associate Vice Chancellor of Heath Affairs.

The case history described by Joy Keeler provides instructive insights into achieving success with CIS and tackling arguably the most challenging barrier of all – organizational culture. Instead of something to be feared, a renewed and revitalized culture can be your most important ally, as Joy Keeler discovered.

Of all the approaches we have practiced and observed over the last 25 years as consultants to the health care industry, we believe the following ten are the most powerful and most likely to lead to making organizational culture your ally vs. your worst nightmare.

1. Create Passion for the Vision, Mission, Values and Strategies Whatever your organization’s reasons for embarking on a CIS initiative, make sure that all key stakeholders know, understand, and embrace the objectives and can articulate "what we are doing and why we are doing it." Success for this huge undertaking will require a ubiquitous commitment to quality care…and many specific goals such as eliminating medical errors, waste, delays, unnecessary variance as well as improving patient satisfaction and your strategic positioning.

2. Measure Readiness Early …and Conduct Periodic Check-ups A formal assessment of your organization’s readiness for CIS will help you understand the major barriers you have to overcome. Assessing readiness and undertaking a readiness improvement effort is as vital for this type of initiative as physical training is for a marathon runner. Readiness can be measured in many ways, including: Technical Readiness, Workflow Readiness, Culture Readiness, Financial Readiness, and Project Management Readiness. We know this is a lot of "readiness," but it's a critical part of successful implementation.

3. Deal with Cultural Challenges Proactively Two very common cultural challenges (courtesy Dr. Jeffrey Rose, CMO, Cerner Corporation) include Infobia, or the fear of appearing incompetent using technology, and Archetypal Medical Tradition, which drives resistance to standards, guidelines, and outside scrutiny. Simply hoping that these challenges will go away by themselves is naïve – intervention in the form of education and skill-based training is required, which will only be possible if all key stakeholders are on board.