The majority of clinical leaders (54 percent) and IT leaders (51 percent) report that they work together on defining system requirements for clinical IT investments, according to a new report.
However, the report also found that clinical leaders are more likely to see the value in going beyond leader collaboration and directly consulting with frontline team members to understand actual workflow. One in five clinical leaders cited taking this approach, according to the survey, with fewer IT leaders taking this approach (only 14 percent). This suggests, the report authors wrote, a potential opportunity for IT team members to shadow clinical staff to truly understand how the clinical IT systems they select will be used in the real-world environment.
In organizations that do not take that collaborative approach, the IT leaders are more likely to take the lead on requirements definition to ensure security and to ensure that the clinical IT systems fit with legacy systems. Twenty-seven percent of IT respondents and 20 percent of clinical respondents cited IT leaders as taking the lead on this.
HIMSS Analytics and health IT company Vocera surveyed approximately 125 clinical and IT leaders from U.S. health systems, hospitals and outpatient facilities during the 2017 HIMSS Conference and Exhibition back in February in Orlando, with the goal of exploring how clinical and IT leaders collaborate to identify and deploy future healthcare technologies.
In the report’s research findings, it is noted that clinical team members at hospitals and health systems increasingly interact with information technologies designed to facilitate, streamline, and document care. For these clinical IT systems to deliver on their promises, they must be designed and deployed in a way that supports rather than hinders clinical workflows and communication. To achieve optimal outcomes, these systems require a new depth and degree of collaboration between clinical leaders who understand medical and nursing care, and IT leaders who understand technical integration and security requirements.
The survey found that clinical and IT leaders agree that the most important value of clinical IT systems is to help safeguard against clinical errors and ensure patient safety. However, after that, opinions across the two groups diverge. “Twice as many IT leaders cited access to clinical data for clinical decision support as a critical function of clinical IT solutions, and mentioned the need to for these platforms to save clinicians time and effort by streamlining clinical workflow,” the report authors wrote. The report authors also concluded that clinical leaders are much more aware of the increasing workload and pressures that are burdening frontline doctors, nurses, and other care team members. “For these leaders, access to data and streamlined workflows hold equal sway,” the authors wrote.
Regarding how organizations assess the need for clinical IT solutions, the report found that the majority of clinical leaders (54 percent) and IT leaders (49 percent) reported that they work together with frontline team members to identify gaps in the care experience that can be filled by clinical IT solutions, according to a new report.
For those organizations that don’t take this collaborative approach, clinical leaders are more often the ones taking the lead, according to 22 percent of respondents, the survey found.
The report also found that clinical leaders see themselves playing a much stronger role in identifying clinical IT solution needs. “They are significantly less likely than their IT peers to see the role that IT leaders play in identifying new system capabilities. Clinical leaders are also far more likely to believe that regulatory requirements shape a significant portion of clinical IT solution decisions,” the report authors wrote. To this point, only 4 percent of clinical leaders agreed with the statement, “IT leaders recognize gaps in current system capabilities and propose solutions.”
Overall, of all the respondents, 22 percent see clinicians identifying challenges and requesting solutions while only 14 percent see IT leaders as recognizing gaps and proposing solutions.
According to respondents, collaboration between clinical and IT leaders continues after requirements definition and into the selection and implementation process. Sixty-six percent of IT leaders and 63 percent of clinical leaders said that they work together in the selection and implementation process. However, only 31 percent of IT leaders interview and observe frontline staff to understand how it fits with clinical workflow, while half of clinical leaders do so. And, few respondents include care team members (only 26 percent) and patients and family members (16 percent of IT leaders and 4 percent of clinical leaders) in the selection and implementation process.
Clinical IT systems have to deliver on a host of outcomes, ranging across quality, safety, efficiency, and experience. Clinical and IT leaders are focused on all of these measures, as well as technical and implementation metrics. When asked how they measure the success of clinical IT solutions, the respondents said:
Clinical measures – 72 percent of IT respondents, 83 percent of clinical respondents
Efficiency measures – 60 percent of IT and 61 percent of clinical
Experience measures –47 percent of IT and 70 percent of clinical
Implementation measures – 63 percent of IT and 65 percent of clinical
Technical measures – 54 percent of IT and 63 percent of clinical
However, clinical and IT leaders agree that the ultimate measure of clinical IT solution success is the impact solutions have on clinical measures such as quality and safety improvement (39 percent of IT respondents and 46 percent of clinical respondents).
Clinical and IT Burnout
The clinical leader survey respondents were also asked about clinician burnout and whether clinical technology and related documentation requirements are key factors. While the issue of technology as a factor in burnout among doctors, nurses and care team members has received a lot of attention, clinical respondents in this survey were actually split about IT’s role in burnout—44 percent cited clinical IT as a significant contributor to burnout, while 44 percent said it is a minor contributor. Further, 9 percent said clinical IT doesn’t contribute at all. Three percent said that clinical technology helps to alleviate clinician burnout.
The report also found that the majority of clinical leaders (76 percent) believe that collaboration between IT and clinical teams to ensure clinical technology improves workflows is key to turning clinical IT into a burnout solution rather than cause. They also point to the importance of system integration to ensure IT solutions work together, cited by 69 percent. More than half believe that workflow and rules engines help prioritize relevant data and tasks (59 percent), and that communication and collaboration platforms help ease the burden of team-based care (52 percent).
On the IT side, the report explored whether the pressure of supporting clinical IT solutions is affecting IT team members. The IT leaders who participated in the survey were asked to what degree are IT teams/IT leaders burned out by the demands of supporting clinical IT selection, implementation and management. Half of IT respondents reported that their teams are somewhat burned out by the demands of supporting clinical IT selection, implementation, and management. Only 9 percent reported not being burned out at all, with the rest being moderately burned out (33 percent) or extremely burned out (9 percent).
Two-thirds of IT respondents (64 percent) cited budget and resource restraints as the top factor contributing to burnout among their teams. Other roadblocks included difficulty working with clinical teams (20 percent), lack of opportunity to do innovative work (17 percent), the pressure of running IT on which lives depend (14 percent), and lack of understanding or support from executive leadership (12 percent).
The report authors concluded the report by noting that while IT and clinical leaders have laid strong foundations for a collaborative approach, there is an opportunity to go further, for example by encouraging more direct engagement between IT and frontline caregivers.
“Successful adoption of technology for clinical collaboration and workflow depends on deeply understanding the context in which frontline caregivers work, and enabling the outcomes they expect. These outcomes include factors related to quality and safety, such as reducing adverse events and injuries, and being responsive to patients. They also include factors related to clinician satisfaction, healthcare quality, and hospital efficiency,” the report authors wrote.
Further, the report authors assert that burnout also has bearing on safety and quality. “The results show that while burnout is a more significant issue for clinical leaders, their IT colleagues are not immune. Greater collaboration between the two groups when selecting and implementing clinical IT systems can play a key role in relieving the burden,” the report authors stated.
Among the survey respondents, 88 percent were from hospitals with more than 100 beds, 15 percent from hospitals with 101-250 beds, 17 percent from hospitals with 251-500 beds, and 56 percent from hospitals with more than 501 beds.
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