How to communicate effectively during your EHR transition [podcast]

“We get too much email.” “I’m in meetings all day.” “I have too much going on to read hand-outs.”

In the workplace, it sometimes seems like communication is the biggest stumbling block to progress. Everyone thinks his or her message is of critical importance, and no one has the bandwidth to dedicate full attention to anyone else’s message.

During an EHR implementation or transition, communication issues are made harder by stress and overwork. Luckily, our implementation experts have been through enough implementations to know where the pitfalls lie – and how to avoid them. Here, Nordic Implementation Strategy Director Lindsey Manzuk, Director of Affiliate Solutions Scott Isaacson, and Director of Business Development Kristi Kempe talk about the components of effective communication plans and how to get the necessary information to the right audiences.

If you’d prefer to read rather than listen, the transcript is below.

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Transcript

Lindsey: Hi, thanks for joining us. My name's Lindsey Manzuk, and I'm Nordic's implementation strategy director. Today we're talking about change management, specifically focusing on communication. I'm here with Kristi Kempe and Scott Isaacson. Hi, guys.

Scott: Hello.

Kristi: Hi.

Lindsey: Do you guys want to tell us a little bit about yourselves?

Kristi: Absolutely. My name's Kristi Kempe. I work on our business development team here at Nordic. I have about 10 years of healthcare IT experience, and about seven and a half of those were spent at Epic. I then independently consulted, and now I'm at Nordic with our business development team and have worked on change management and organizational readiness throughout my entire 10 years in healthcare.

Scott: Great. Thanks, Kristi. My name is Scott Isaacson. I'm on the affiliate team here at Nordic. I also have 10 years of experience. I started at Epic. I worked as a full-time employee at an Epic customer and then started consulting. I joined Nordic about three years ago, and about a year and a half ago, took my current role as Director on the Affiliate Solutions team.

Lindsey: Great. So, communication strategy — I don't think it's a surprise to anyone that it's a critical component of effective change management. But what I'm hoping we could talk about today is how do you have an effective communication strategy? Any initial thoughts to kick us off?

Kristi: Sure. I think it comes down to — as a lot of things do  setting the right expectations. If you set expectations throughout your project, it's not going to feel so harsh or so drastic because people will know that the change is coming, and they'll know that throughout the phases of the install.

Scott: And I would say even with expectations, or along with expectations, comes consistency. So, once you set those expectations, making sure that communication is consistent so they know what to expect, but you also follow through on kind of those expectations.

Lindsey: I also think one thing that customers can do is make sure they're talking to their implementation project team about communications with their operational SMEssetting expectations for regular meetings, going to department meetings, what that should look like across the board so you have consistency and appropriate expectations, again, from an IT project team to an operations standpoint. As far as a communication plan, what are some components that you see really effective communication plans have?

Scott: I guess the first thing I would comment on is making sure that you think about what the audience is and what's the best way to communicate to that audience. And considering the audience may not be just internal to your organization, so in the affiliate world, you also have to think about communication internally, so what do all the internal projects stakeholders need to know and when? But also what do the affiliates need to know and make sure that they're kept up-to-date kind of from Day 1 of the engagement. Then I think it goes even a step further: what do folks outside of your organization need to say? So, patients, folks in the community, things like that should also be considered as part of your communication plan.

Kristi: It's important as well to think of the next level of communication, so whether you're communicating to your project team or to your operational stakeholders, what is their responsibility after they read the email or leave the meeting? What expectations can they communicate about their project, and what is really the most important message for them to be bringing back to their unit, or department, or clinic.

Lindsey: I think I definitely see different messaging based on the audience, which is appropriate. It’s about thinking about the audience, the messaging, and the timing, making sure that those are all appropriate.

Kristi: I've seen that successful, Lindsey, especially with email communication. We’ve all heard that no one reads emails. It’s important to target your emails, not necessarily to different audiences, but to at least call out in those emails to a particular end user base if it's communication to end users, so your providers versus your nurses, versus your patient access coordinators, to draw their eye to the stuff that applies to them even though the overall message might apply to them as well.

Scott: Kristi, have you seen any particularly good techniques in terms of flagging things or coloring things when it comes to those kind of communications to help draw different audiences to the appropriate part of their communication?

Kristi: I think the biggest thing that I've seen is separating communications from a clinical and non-clinical standpoint. There are things that will not apply, and that is the quickest way to get your users to not read a particular email. Any sort of differentiation between who the target audience is lets them know that you're thinking about how you're differentiating your users and trying to make the most of whatever communication mechanism you're using.

Scott: I definitely think that adds to your credibility when it comes to communication.

Lindsey: I've also seen organizations be really successful when they've leverage their champions to be a level of review for those communications, especially if they're written. And then if they're verbal, actually using the champions to deliver them to the appropriate end user groups.

Kristi: And if it's coming from them as opposed to coming from a generic project email, that's something that I've seen successful. It makes it a little bit more logistically challenging, but to see an email from someone they know, it's more likely to get read.

Lindsey: Yeah. So, Kristi, you mentioned emails, what other sorts of communication mediums have you guys seen be successful?

Kristi: Sure. Breaking it down, there are those push-outs from your project team or your executive leadership. We talked about email, certainly project newsletters, paper documentation I've seen especially in hospital units  having that paper they can touch is beneficial or post in their break room. Those typically can get read a bit more as well as change management events or project-base adoption events are successful as well.

Scott: I would also say from the affiliate standpoint, it's important a lot of time to think about doing road shows, and system demonstrations, and things like that to really get engagement and make it as real as possible for those affiliates that are out there so they really understand that change is coming, "This is a sneak peek of what it looks like." It often generates a lot of positive buzz on the project as well. And then we also really rely on account management, which is a role that we find really critical when working with our affiliates. It's basically the affiliate's best friend. In-person typically works best, face-to-face across the table, to have those discussions and really forge those relationships as part of that partnership.

Kristi: I'd say there's some other methods as well. You are relying on folks to go out and seek the information, so a project SharePoint site or knowledge library or a repository a lot of times for different aspects of the project can be useful. Here is your one online resource for training and training registration. Here's your resource for the workflows we went through in adoption sessions. An effective SharePoint site or project websites makes it easy for people to go seek information and stay well-informed.

Scott: From the affiliate standpoint, we also see most organizations will choose to do some website marketing, so as folks are using search engines and looking around for a potential partner for Community Connect, you'll have a presence there. Consider going a few steps above and beyond as well – so providing them with either a unique login, or a backdoor login, so they can get in and access specific tools once they're actually a Community Connect customer. One example is, "What are policies and procedures that are affiliate-facing, and where can I get access to those so I know if I have a new user who has a question about access or how to do something? Where can I go pull that information?" But still keeping that information private to you and to your affiliates can work really well.

Kristi: I just thought of another one, too. A big kind of lesson learned, or tip, would be record everything — so videos or demos that your provider champions are doing, that your project team is doing. Especially for tricky workflows or for topics you want to highlight, you will probably need to reuse those and record them. Post them on those websites, and then people can watch them, especially if it's a demo within the system, has been super helpful.

Lindsey: Yep. I also had a customer that asked their CEO to do a Q&A session. They recorded it, and it was one of their top-viewed videos in the history of the organization. Can you guys talk a little bit about how organizations can leverage existing structures that they might have in place — governance meetings instead of building brand-new communication?

Kristi: We hear a lot about meeting fatigue and there aren't enough hours in the day, so how am I going to fit in this "Epic meeting"? You can't see me, but I'm air quoting Epic meeting. The answer is to take advantage of your existing meetings. I know it might be hard to find time in the agenda, especially if you're meeting monthly or quarterly, but build Epic workflow topics into those existing meetings.

Whether it's your departmental meetings, rounding meetings for your clinical staff, staff meetings, resident meetings — any type of existing meeting. It's easy to build in a five-minute Epic topic. You can have any variety of people speak to those topics.

In referencing back to some of the things we've said about planning your resource requests, maybe you have someone from the project team come and do a demo. Plan that in advance. Maybe you have a super user talk about something that they ran into in class that will be really challenging for your clinic. There's a lot of different resources you can use in those existing meetings to start the conversation about change early and consistently throughout your install.

Lindsey: When I think about governance groups, governance can be a really great spot to share a message across a wide variety of stakeholders so you're getting consistency, and there's a chance to ask questions and have discussions. Definitely leverage those both as a decision-making tool and as a communication tool.

Scott: Absolutely. We find that important on the affiliate side of the house, especially as you have your invested partners — who are your affiliates — take part in governance meetings. It's a great place to both gather some information, but as well as to disseminate the same message across all of those affiliates so they're all feel that they're on a level playing field.

Lindsey: And don't forget your project team as you ... as kind of the trickle-down from those executive meetings. Make sure your project team is informed from those executive meetings as well, so not only is the executive team on the same page, but it's trickling down to the folks that are living this day in and day out.

Scott: And from a Community Connect perspective as well, it's really important. You may have a separate Connect team, but it's important that your core team — who will be doing support and things even as simple as your help desk — are aware of what's happening with Community Connect, because the worst thing that can happen is one of your affiliates calls into the help desk and gets turned away because the help desk isn't informed that they are actually one of our customers and they need to be served just as though they were internal.

Lindsey: That's a great point, Scott. One other thing I'll mention, because I see organizations not plan for early, and then they try and rush at the end, is thinking about any policy and procedure changes and how you're going make sure that the users are informed about them. This is especially true for old policy versus new policy. Some customers try and do that in training, sometimes you can't handle all of that in training, so are there other strategies that you need to deploy to make sure that those are effective?

Scott: We often find that can easily get overlooked in the Connect space as well. These small organizations may not have a robust privacy and security policy, but as part of their partnership, we expect them to have virus scan, and a firewall, and all of these different things out there. Starting early and often with those communications and expectations, as far as how their day-to-day may change, as part of policies and procedures in that partnership.

Lindsey: All right. One other thing I want to ask about is staffing. So, during implementation, what sorts of roles do you typically see do the communication work? What have you seen work well? What have you seen not work well?

Kristi: This is something that I sometimes push back on, but there does need to be in your install a dedicated person, communication director. It can't be another task that your project director undertakes, which I know is tough from a resource standpoint, but it’s important given the amount of communication that needs to happen. We have seen it be successful when we have a dedicated communication director role during that pre-implementation and implementation timeline.

Scott: Absolutely. I think we also find a lot of times when there is that dedicated resource, it provides a very consistent voice for the messaging and also makes sure that everybody that we're communicating to can get the same message.

Lindsey: I have worked with a lot of organizations who have a marketing or a PR team, and I do think it is important to involve them. They have a lot of knowledge, maybe they have templates or tools that can help you by having that dedicated person sit on the team and understand the day-to-day of the project and then liaise with that marketing team can be successful.

Kristi: I also recommend having a person from that team or someone with more of project management skills attend your early sessions so they can start becoming familiar with the language of the EHR and the language of your Epic project. If they attend at the beginning from a marketing perspective, then they have that foundational knowledge that will carry them throughout the install.

Scott: I've also seen that particular individual integrated right in the project team right at the leadership meeting level, which was very helpful because they understood the decisions that were being made and then worked together with the leadership team as to how those would be communicated. Obviously there are some things that you talk about at the leadership level that maybe shouldn't be communicated, or should be communicated in a particular way, so it's great to have that person integrated there.

Kristi: Involving someone from that team can help emphasize your internal communication versus your external communication, so internal project team operations, your normal mechanisms within your facility as opposed to external billboards, any type of fliers or handouts. Involve the folks that specialize in patient communication at your organization early. A lot of time I see people saying in the month before go-live, "We've talked about the material that we're going to share with our patients. We've talked about the message. Now we need to get it on paper. Does anyone have examples of that?" So feel free to share examples of that with each other. I know most folks that I've worked with have created that message, so don't forget that patient messaging and printing of those materials, signs in the elevators, things like that.

Scott: It also comes down to a lot of times even things like consent to treat, so that may have to change as either your organization goes through an HER. Or if you're an affiliate that's now taking part in somebody else's instance, your consent to treat may change, and also your patients need to be aware of that your data is now shared beyond just your clinic. It's now shared with your hub organization as well, and people need to be informed about that.

Kristi: Talk about a modeling task for your clinician champions. Provide examples of how to talk to your patients about what's happening with the EMR. It's really easy to say quickly, "We have this new computer system," but what's the "why" behind that? What is it going to change for them as a patient? I've seen that be very successful as well.

Lindsey: Great. And then post-live, I typically see communications be more of a part-time job. I'm curious if you guys have also seen that?

Scott: Absolutely. I would say as it becomes a more regular and methodical process, that person that was heavily engaged in doing a lot of that communications would remain in that role. It’s great having that organizational and decision- making background. But, typically, I do see them slot back into their older role while still maintaining part-time on communications.

Kristi: I agree. I think this is one case where, if you do have that person from one of your existing marketing communications team, definitely backfill their other job role and their other job requirements as they take on this project communication role. Then after go-live, it does tend to shift back and they can return to more of their full-scope duties as opposed to just focusing on the EMR project.

Lindsey: Scott, any additional thoughts from an affiliate standpoint? I know it's a different strategy.

Scott: Absolutely. Make sure that your communication plan is there to support that partnership. Now that you're a vendor, you need to make sure that they have a crystal clear understanding of expectations, what's happening, what their weekly curriculum looks like. If they're uncertain about it, they're not going to feel great about the project, so communication can really be that first line of defense to make sure that you've got a strong partnership. I think it's also really important as your affiliate programs grow to make sure that they all have access to the same information and are treated the same. That goes for decision-making — regardless of your size, your specialty, your location, or your political clout, you should all have the same kind of decision-making process and abilities — but also making sure that all communication goes out to everybody so everybody's aware of them. Those are just a few tidbits from the affiliate world.

Lindsey: Great. Thank you very much. Any final thoughts before we conclude?

Kristi: None from me.

Scott: I'm good. Thanks.

Lindsey: Thanks for your time.

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Topics: communication strategies, Epic implementation

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