Implementing IT in Healthcare: Changing the Healthcare professionals mindset (1)

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Implementing IT in healthcare Changing the
Healthcare professionals mindset

• Dr Colin Fincham MBBS LLB(Hons)
• Chief Operating Officer Intellehealth
• Programme Director Wareed UAE

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Agenda

• The Wareed Programme
• What makes people use HIT
• What stops people using HIT Barriers to
  adoptions
• Why are physicians so important in Adoption
• Central role of change in adoption
• Approaches to manage change

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Wareed

• 14 Hospitals
• 68 Clinics
• 98 Other facilities
• 7000 users
• Biggest IT implementation in the Region
• 14 Hospitals Live 13 in 14 months

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Some Stats

• July 2012
• 69,000 OP appointments
• 57,000 New Regs
• 5,300 IP admissions
• 17,500 Xrays
• 146,000 Medications on
• 31,000 Pts
• 268,000 Lab assays
• 378,500 notes signed

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Computer systems cannot improve organizational
performance if they arent usedDavis, F.D.,
Bagozzi, R.P. and Warshaw, P.R (1989) User
Acceptance of Computer Technology comparison of
Two Theoretical models, Management Science, 35,
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Why do it?

• One large childrens hospital in the US
• Medication errors causing patient harm decreased
  by 30
• Medication errors per 1000 patient days decreased
  23
• Allergy documentation improved 33
• Incomplete orders decreased by 67
• Over 4 year span, EMR saved 22.4 Million

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User acceptance of computer Technology
Davis 1989
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Barriers to Health Information Technology (HIT)
adoption

• High costs
• Workflow functionality
• Misaligned incentives
• Disconnect between who pays for EMR systems and
  who profits from them
• Culture of medicine
• HIT -lack of certification and standardization
• HIT -Lack of interoperability
• Concerns about privacy
• Ease of use issues

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Physician resistance is ingrained

• That it will ever come in to general use, not
  withstanding its value, is extremely doubtful
  because its beneficial application requires much
  time and gives a good bit of trouble both to the
  patient and the practitioner because its hue and
  character are foreign and opposed to all our
  habits and associations
• London Times
• 1834

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What was being discussed?
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Clinical adoption is critical

• Physicians had always avoided applying
  mathematics to the study of the body or disease.
  In the 1820s, 200 years after the discovery of
  thermometers, French clinicians began using
  them.
• Aspirin and Beta blockers as standard of care
  discharge medications post myocardial infarction
• Accepted over 25 years ago
• Current state adherence to practice 4050

• The Great Influenza The Epic Story of the
  Deadliest Plague in History, John M . Barry p25

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How do you overcome resistance to change

• Anyone who thinks you can overcome emotional
  resistance with logic was probably never
  marriedor worked in healthcare

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Change
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Principles of Change
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First rule do no harm

• Despite the cost pressures, liability
  constraints, resistance to change other
  seemingly insurmountable barriers, it is simply
  not acceptable for patients to be harmed by the
  same health care system that is supposed to offer
  healing comfort

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Principles of Change
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Frame the WIIFM correctly

• What is the most dangerous instrument in health
  care?

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What is the outcome?
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Frame the Adoption
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Principles of Change
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Tackle the Physician appropriately

• Altruistic
• Professional
• Evidence-Based
• Leader
• WIIFM
• Different people need different approach one size
  does not fit all

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All users will be at different points
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Principles of Change
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You cant do it alone
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Principles of Change
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Execute on the strategy

• Change can be considered in 3 areas
• Political Campaign
• Marketing Campaign
• Final Exam

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Political Campaign
Get your vision message out

• Patient safety
• Visit the masses
• Tell them what you are going to tell them
• Tell them
• Tell them what you told them

Engagement

• Right people at the right time

Communication

• Communicate, Communicate, Communicate some more

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Marketing Campaign

• Focusing on selling (demonstrating) solutions
  that resonate with the target audience
• Engage users to become owners
• The best sales people are those peers who believe

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Final Exam Every day
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Vision Execution Successful Change

• Good Luck

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• Dr Colin Fincham MBBS LLB(Hons)
• Chief Operating Officer Intellehealth
• Programme Director Wareed UAE
• Colin.Fincham_at_icapital.ae
• Follow on
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