There is value in applying strategic marketing principles to the rollouts of electronic health records (EHRs) in patient care organizations, argues Doug McCourt, president and chief operating officer of company M, a Palm Springs, Calif.-based marketing services and managerial consulting firm. McCourt, and Ann Farrell, a principal in the Towson, Md.-based EHR consulting firm Farrell Associates LLC, were recently interviewed by Kim Cloidt, director of marketing and communications, for company M, on this topic.

The use of health information technology tools, within healthcare settings, is no longer limited to clinicians. As patients become more active participants in the management of their health, these IT assets have become valuable resources for improving the patient experience. 

To gain internal support, and set patient expectations for what technology can do for them, IT departments need to tell their stories more effectively than ever before. But devoting time to honing communications skills and PR mechanisms adds increased pressure on IT teams already stretched by high demands and tight delivery schedules. How can all these different issues be managed? McCourt, Farrell, and Cloidt recently discussed the issues involved. Below are excerpts from their discussion.

Kim Cloidt:  Ann, Doug, tell me a bit about your background and why you are so passionate about Smart Marketing.

Ann Farrell: My roots are firmly at the bedside.  As an emergency department RN at El Camino Hospital in California, in the 1970’s, I was excited to be part of the deployment of the first commercial electronic medical records system.  I worked with an exceptional executive, clinical and IT team and the lessons learned fueled my passion for improving the clinician and patient experience.  Since then, as the first RN-EMR-R&D executive, and now the leader of a strategic HIT consulting firm, I work to bridge the gap between these same communities and promote success strategies as a clinician and patient advocate. 

Doug McCourt: I cut my teeth in the industry installing health IT solutions, teaching/training users, and providing support 24/7.  Throughout my experience, effective communications has always been important.  However, today, with massive rollouts of EHR functionality combined with the requirement for all clinicians and patients to use the EHR, it’s critical that fundamental communication activities be factored into every single EHR deployment plan.  The IT teams can’t assume that professional (and actionable) communications will magically happen or that some other department will handle it.  IT departments need to be an integral contributor to effective communications.

Cloidt:  Within consumer-driven industries product roll-outs are only successful when marketing and communications programs are an integral part of the project.  In your opinion, why isn’t this same approach taken for EHR deployments?

McCourt:  In my experience, it comes down to expertise.  CIOs and their teams simply don’t have communications and PR skills in their DNA.  As a result, they often feel that the HR or PR department should own communications and that IT is strictly focused on technology.

Farrell:  You’ve heard the expression “Men are from Mars and Women are from Venus.” Well, when it comes to IT and clinicians, the comparison is the same.  Each has a different perspective that may need translation to support better collaboration.  For example, IT worries about budgets and schedules whereas clinicians worry about ease of use and improving patient outcomes.  But together, they can achieve both objectives by focusing on the positive results accelerated adoption will achieve. This is accomplished with proactive and sustained communications.

Cloidt:  Internalcommunications for physicians, clinicians and employees have traditionally taken a back seat during EHR implementations.   Why?

McCourt: In my experience, there are three important reasons why this happens. First, the business of healthcare delivery is more complicated than other industries. Successful, market-driven businesses typically have excellent internal communication programs as well as a communications team who use savvy PR and communications techniques to reach their B2B partners, distributors and consumers. EHR roll-outs, as well as other health IT initiatives, are now integral components of effective healthcare delivery.  Proactive and comprehensive communications programs and “smart marketing” techniques are no longer a luxury:  they are a must. 

Next, care delivery organizations may not employ all of the physicians that drive patients into their care delivery system. Therefore, even if moderately effective internal communications exist (i.e. secure employee intranet); external doctors may not have access and thus may be excluded from key internal communications.  If for a moment we think of doctors as B2B associates, it’s critical to expand internal communications mechanisms to reach these external physician partners.

Finally, PR and communications are simply an afterthought.  During an EHR rollout, a tidal wave of work-effort (and cost) hits the organization, and the focus, as I mentioned before, is on the technology.  Planning for effective, on-going communications must be moved upstream and factored into the initial EHR project plan.

Cloidt: How has the emergence of the CMIO role impacted EHR communications?

Farrell:  The role of the CMIO has been evolving dramatically from information technology advocate to senior leader helping to move their organization up the quality scale in both improved care and clinician efficiency.  With this expertise and leadership, the CMIO is in a unique position to bridge the gap between IT and clinicians because they speak the language of both groups.

Cloidt: What does an effective communication strategy and plan entail?  And, what’s involved in launching and maintaining such a program?

McCourt:   That’s a big question, Kim.  First, establishing an integrated, professional IT communications program should be approached the same manner as any other important project.  It requires the establishment of goals, project planning, and identification of challenges or obstacles, as well as ample resource allocation.  Bottom-line, it requires a structured project plan as well as an owner of the communications plan.

I often ask my clients how they can require clinicians to enter orders electronically, seek best practices on-line and improve patient engagement if they still send paper-based instructional memos and newsletters through the postal service or by fax.   It’s often a great “ah ha!” moment.  When launching the program, it is critical to use contemporary communications tools, such as the web, intranets and text messages to effectively reach your audience

Lastly, it’s essential to develop and constantly maintain distribution lists by role.  This is a gigantic challenge because quite often communications are fragmented across a diverse departmental landscape.  However, cleaning-up, centralizing, and automating through a contact-management tool will improve the speed of communications and enhance the ability to craft appropriately targeted communications.

Cloidt:  That makes a lot of sense Doug.  Are there any tips you can give CIOs which can help them fast-track the communications development and maintenance process?

McCourt: I’m glad you didn’t use the phrase, “cut corners,” Kim.  Communications is a mission-critical activity.  There are ways to develop an IT communications platform that can re-purpose and centralize existing communications mechanisms that may already exist in other departments. 

When launching a new EHR initiative, start early by integrating the communications plan and key milestones into the overarching EHR project plan.  Don’t wait until training activities are launched; that’s too late.  As the EHR planning process matures the executive team must review and support milestones, activities, costs and resource requirements which must also include communications-related work.  Surprising the executives late in the deployment with unplanned work and costs is a recipe for failure.  By starting early, the owner of EHR communications, in collaboration with a cross-departmental communications team, will have ample time to work through many complexities and develop appropriate action plans.

Cloidt:  When you say “team,” Doug, what do you mean?

McCourt: The designated leader/owner of EHR communications can’t act alone; it’s a collaborative team exercise which should be charted and governed in a formal manner.  More importantly, the organization needs to realize that various groups often have different and/or conflicting goals and priorities that need to be aligned.  It’s critical early-on to differentiate the unique impacts the new EHR will have on each constituency so that messaging can be customized.

Cloidt:  We’ve seen a backlash in fast-paced EHR implementations with lower than expected adoption and satisfaction rates with physicians, clinicians and staff.  If a short time period is necessary for technology implementation, what can be done to improve adoption?

Farrell:  EHR adoption starts with “useful and usable” solutions.  Dr. Mostashari, national coordinator for health information technology, recently implored vendors to focus on this, before adding more bells and whistles.    The shortened timeframes for adoption encouraged by MU make timely and effective communications all the more important, but ultimately the usability of EHRs will drive improved satisfaction.