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Getting Physicians to Buy-In for Clinical Transformation

May 1, 2014
by Gabriel Perna
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Sarah Cotter; David Nielsen; Tanya Thomas, R.N.; Jon Nielsen, M.D.

When it comes to innovative, transformative clinical projects that are enabled by health information technology, those that have been successful are getting physicians to buy-in through a variety of strategies.

Speaking at the Healthcare Informatics Executive Summit at the Mark Hopkins Intercontinental Hotel in San Francisco, a pair of Innovator award-winning teams at North Memorial HealthCare and Catholic Medical Partners talked about the importance of keeping physicians involved and engaged in these large-scale initiatives. The panel, “Working with Physicians to Achieve Clinical Transformation,” touched upon how those organizations took on this often-difficult task.

At North Memorial, leaders were able to reduce or eliminate unjustified inductions of child labor prior to 39 weeks’ fetal gestation at the 300-bed North Memorial Medical center in Robbinsdale and the 100-bed Maple Grove Hospital in Maple Grove through the use of an electronic data warehouse platform and advanced healthcare analytics applications. At Catholic Medical Partners, which consists of a network of more than 900 independent primary care physicians, pediatricians and specialists, along with local hospital partners, leaders have achieved enterprise-wide population health, based on clinical data exchange and EHR quality reporting.

In both cases, getting physicians to buy-in to the initiative was essential to its success. Sarah Cotter, director of clinical transformation at Catholic Medical Partners, said that Catholic Medical made a big push for clinical involvement in governance. The quality metrics used by Catholic Medical Partners were picked out by a select group of physicians from the organization. This gave the initiative credibility in the eyes of the other doctors, Cotter says.

Additionally, Catholic Medical Partners motivated its physicians to get involved by letting them know that the data captured for their practice “was their data,” Cotter said. They also worked directly with them on optimizing the electronic medical record (EMR). “We have a team that focuses on improvement within these practices,” she said, adding that they’ve created group programs in this realm.

At North Memorial, Tanya Thomas, R.N., nurse clinician in the family birth center at Maple Grove Hospital, said they created a “culture of respect,” where clinicians, quality improvement people, the data analysis side, and other thought leaders all appreciated each other. Indeed, Jon Nielsen, M.D., a practicing gynecologist at Maple Grove Hospital and the medical director of the system’s Women’s and Children’s Service , said they were able to get buy-in pretty quickly. Leaders at North Memorial also would go to the physicians directly, Thomas said, and would explain why the initiative was the right thing to do and worked through questions and concerns the doctors had.

In neither case, money was not the key to the heart of getting physicians involved with these projects. While there are incentives in some cases, such as at Catholic Medical Partners, it wasn’t the overwhelming driver of involvement. David Nielsen, director of IT and Internal Operations at Catholic Medical Partners, said the money was fixed and they couldn’t give the doctors any extra financial incentives. Instead, doctors were emboldened by being able to work more directly with the patients, while care coordinators and nurses worked on other duties. Dr. Nielsen at North Memorial said their ob-gyn doctors didn’t get paid and still came to evening meetings on the project.