I have sat through a few presentations with titles such as “What Went Wrong With Our CPOE Implementation.” A recurring theme in those powerpoint slides is a perceived “lack of strong senior managment support.” In my opinion, this is an incomplete analysis.
Is it really the case that senior leaders are too lazy or uncaring to champion these new information systems? I don’t think so. I think the trouble lies a little deeper. I suspect the scenario goes like this:
- The project folks go to senior management to dsiscuss adoption problems with the hope that they will “force” the physicians to use the system.
- The CEO or COO approach the top admitters to discuss the situation.
- The physician responds by stating that the system sucks and s/he would rather practice at the competing hospital than use the system.
Is it really strong senior leadership that would turn away a significant amount of patient revenue and jeopardize the ability to fund the mission of the organization?
I think the real issue is that the planning and anlysis failed to ask some real hard questions about the risk of physician resistance and the limited options the organization may have in that event.
I also think that usability has to be a primary focus and it may be that most products are not to a state that they are easy to use.
Hospitals with hospitalists and teaching staff have an advantage. But even those will have a large number of physician customers that can take their business elsewhere.