Clinicians and staff at Northwell Health’s Northern Market, the legacy Nuvance Health hospitals in western Connecticut and New York’s Hudson Valley, had been communicating across three separate systems: patient texting out of the EHR, a separate texting tool for clinicians, and email and Microsoft Teams for operations staff.
Albert Villarin, MD, vice president and chief medical informatics officer of the Danbury, Conn.-based Northern Market, wanted to replace all three with one platform.
“So everyone was all over the place. I wanted to have a goal to unify, have a unified communications platform that we can use to facilitate all communications at every level,” Dr. Villarin said.
The platform would connect to other systems, with access toggled based on each user’s role. The team ran a request for proposals, chose the product Dr. Villarin considered the best on the market and began bringing sites live.
Nearly every group signed on. One did not.
“Everybody bought in, except for the clinical people because they were so ingrained in their current state platform that they used for many years, they didn’t want to give up that knowledge,” he said.
The resistance didn’t run evenly across clinicians. At one site with strong nursing executive leadership, nurses took to the platform quickly.
“The nurses were very happy with the platform. They loved the platform because they could go back and forth between different entities and get the information they need, rather than logging in and out of different systems of the same communications,” Dr. Villarin said.
Physicians wanted something narrower.
“The physicians, on the other hand, didn’t need to care about the other aspects of communication; they just cared about texting one another and texting the nurse about a patient. They couldn’t care less about everything else that was being successful, and because of that, they didn’t want to leave that little bit,” he said.
Workflows between nurses and physicians also proved difficult to navigate, depending on which site was going live. A technical integration problem added to the drag. The team was working toward a fix, but onboarding stretched across nine months to a year, and the pushback from clinicians kept coming.
Dr. Villarin and other leaders, including the chief medical officer and CIO, met to decide whether to keep going.
“We sat together and said, ‘Look, is there a benefit here in pushing this forward?’ And we decided at that point that there wasn’t, so we held it off,” he said.
The pause didn’t mean writing off the purchase.
“We made the investment. We got out of it what we needed to a certain extent, so we didn’t lose money. We just lost time because the other development wasn’t successful,” Dr. Villarin said.
That time was substantial: About four or five analysts, leaders and managers from the acute and ambulatory sides spent roughly a year trying to get the platform adopted.
For Dr. Villarin, the problem was who owned the change.
“Change management is very important. So change management had to come from three areas, not just IT, but clinical and operations as a trifecta,” he said.
Next time, he said, he would look at how other organizations succeeded with a similar tool and bring those teams in to talk directly with his clinicians. He sees the same challenge in the system’s current push into AI.
“Just like we’re doing with AI right now, there’s a lot of moving pieces. We have to focus that message and make it successful for moving from scribes to the automation of AI,” Dr. Villarin said.
He still believes in the idea behind the project.
“We just were disappointed that we had a great idea, all of us, and we couldn’t bring it to fruition. So I kind of take that personally, but I also understand that there are many multifactorial reasons why it wasn’t completely adopted,” he said.
Editor’s note: This is the second installment of a recurring feature. Read the first installment here. Email gbruce@beckershealthcare.com with other examples.
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