I recently had two useful pieces of information come to me that illustrate my thoughts on achieving user buy-in to an electronic health record.

One was a tip on blogging from our blog host. It introduced me to the acronym WIIFM. The tip reminded us that readers search for and look at blogs, asking, “What’s in it for me?”

The other information was told to me by a nurse turned techie/implementer in a large system with over 10 institutions. She described the implementations in two of their facilities. In one, the implementation focused on creating reports for the needs of the top managers. In the other, the implementation team created reports designed to meet the needs of the clinical staff. For example, they created a shift change document for nurses and a report showing treatment permissions coming up for renewal. She described that in the first facility, the implementation had a difficult time winning over clinicians. In the second facility, the clinicians had a much more positive attitude and the implementation went much more smoothly.

I believe WIIFM is an absolutely legitimate attitude for a CEO, a supervisor, or a clinician using an EMR. After all we’re talking about the relationship of a user to an electronic health record system It may be long-term but it is not an intimate relationship.  WIIFM is OK. So, implementers, ignore it at your peril!

I’d love to hear more stories about where WIIFM fits into your implementation.

          The case for implementing an EHR depends on your point of view.  In this blog, I want us to consider the question from a CEO’s perspective. CEOs spend much of their time monitoring enterprise performance and preparing for and making decisions. This is as true for executives in health care as for those in automobiles and banking. Volumes have been written about these high level tasks and, for sure, I don’t have new insights to add to that body of knowledge. What I want to highlight is the crucial contribution information makes to CEO oversight and decision-making. Courtesy of Wikipedia, I define Information to be "the result of processing, manipulating and organizing data in a way that adds to the knowledge of the receiver." In the domain of health care, information must include data captured through an electronic health record (EHR).  Here’s how this played out at my home organization, University Behavioral HealthCare (UBHC). 

In the mid 1990’s UBHC faced the surging managed care environment with its demands for effective care at lower prices, its requirements for accountability for documentation and outcomes and its focus on customer satisfaction. Our CEO recognized that in order to succeed in this environment the organization needed to use information to:       

• Establish and monitor care and productivity standards
• Optimize and monitor billing 
•  Identify service supply and demand trends  
•  Measure treatment efficacy and patient satisfaction

He further recognized that to accomplish these tasks, he needed the data to be comprehensive, detailed, high quality, and current. Relevant data from all functions of the enterprise had to be captured electronically for executive management control and reporting purposes. For our CEO this case for implementing an Electronic Health Record System was compelling.