David Burda’s piece on physician anger with Electronic Health Records is interesting (Alexis Polles is the original presenter).  Modern Healthcare’s Daily Dose suggests these frustrations are related to poor design and poor training.  Of course excellent design would minimize the need for training.  I agree with that take.

However, the original speaker seems to indicate that some physicians are unable to adapt to this way of practicing medicine.  Our experience is that 1 to 2 percent of doctors may have trouble embracing clinical IT (regardless of design and training).  As you prepare to roll out your clinical IT systems I think it is critical to know how you will handle that 1 to 2 percent.  I hear a lot of people talk about a “lack of senior management support” with clinical IT efforts.  I think we put senior leaders in a tough position when the checks are signed and the physician problems beginning to pop up.  If you have that conversation in advance and agree on the course of action, we will find senior leaders more support.

It will be useful to discuss some real uncomfortable scenarios.  What if the one physician hold-out is your top admitter?  What if you are experiencing 10% physician resistance?  Too often we sugar coat these challenging projects.  That will really cause a lack of senior leader support when your EHR or CPOE effort turns out to be something other than the bed of roses it was portrayed.