The customer isn't always right, says Avaap CMO Dr. Craig Joseph: 3 questions on gaining physician buy-in, health IT misconceptions and the new patient experience

In this special Speaker Series, Becker's Healthcare caught up with Craig Joseph, MD, CMO of Avaap, an IT services and solutions provider for organizations that use Infor and Epic enterprise software applications.

Dr. Joseph will speak during the Becker's Hospital Review 4th Annual Health IT + Revenue Cycle Conference on "Why the Best CIOs May Be Missing the Biggest Revenue Opportunity," at 1:45 p.m. Wednesday, Sept. 19. Learn more about the event and register to attend in Chicago.

Question: How does your organization gain physician buy-in when it is implementing a new technology or solution?

Dr. Craig Joseph: When working with physicians to implement some new EHR functionality or a different way to communicate with clinical staff, I always focus on three things to gain buy-in: transparency, honesty and context. It's essential that the project team, and executive team for that matter, be fully transparent about what the new technology brings to the table. This means good, bad and indifferent. Doctors are smart people; they'll see through attempts at hiding high-tech warts. So, I bring any of these front-and-center right at the beginning. With transparency comes honesty: Few projects or tech implementations are perfect or fully beneficial to all involved parties. I recommend dealing with these issues forthrightly; attempts to pull the wool over physicians' eyes never succeed. Lastly, I think context is essential so that the doctors understand that a particular decision may not benefit their specialty, but may be very helpful to the ED staff or primary care physicians. When they see the big picture, they'll often be much more understanding and flexible.

Q: What's the biggest misconception about health IT?

CJ: I'm going to take this up a level and tell you what I think is the biggest misconception in IT generally: The customer is always right. No, no they're not. I've seen many healthcare IT projects go off the rails or not fully succeed because the project team asked the doctors and nurses what they wanted and then gave it to them. I'm a big believer in the theories and principles of usability. There is science about how humans interact with technology; hence, we on the IT side often know the answer to questions we commonly pose to end users. If we know the answer, we should not ask the question. If you think about it, the IT analyst is the subject matter expert when it comes to implementing tech, not the physician. I liken this to imagining an anesthesiologist asking her patient in the pre-op area how she'd like to have her anesthesia induced. That would be a crazy question, but this is what we do in IT everyday. What actually happens in the pre-op bay is that the physician tells the patient, "Based on your history and my experience and learnings, I plan to anesthetize you this way. There are other ways, but they're not as good because of this and that. Should we move forward with my recommendation?" I try to get my IT folks to approach implementation of technology in the same way: "This is how the technology should work and why we think that. There are other options, but they're not as good because of this and that. Should we move forward at this point, or did we miss something during our discovery process?"

Q: In the past 12 months, how have you adapted to new patient experience expectations in the age of consumerism?

CJ: I'm excited about consumerism. I see it as a way to help focus decisions that hospitals and healthcare systems make, especially around healthcare IT. We often ask questions like, "How will this affect the doctors?" or "Which option will most easily get approved by our compliance folks?" But until recently, I rarely heard "How will this decision impact the patient experience?" That question is omnipresent now, and that's a good thing. Frankly, I don't see many formal or procedural changes in how we do what we do with respect to consumerism, so adaptation isn't so much at the forefront. What is more important, though, is that leaders are taking patient experience into consideration at the onset of the project. How the patient interacts with the health system and what they think about dealing with us is the first question we ask, not the last.

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