Barriers, Strategies, and Benefits to Physician Advisory Committees
After the implementation or optimization of a new EMR system, a common complaint is poor physician adoption or physician dissatisfaction. Here are some of the key factors that typically lead to physician resistance to new systems and processes:
- Poor EHR usability, training, and support
- Poor communications
- Compromised patient-physician relationships
- Compromised work-life balance
- Compromised financial security
- Lack of physician governance and engagement
There are a number of ways to address these barriers and overcome physician resistance to develop satisfaction. Some of the keys to fostering physician satisfaction include:
- Physician governance
- Physician engagement and communications
- EHR usability design, training, and support
- Preserved patient-physician relationships
- Preserved work-life balance
- Preserved financial security
While these solutions seem simple enough, it’s important to take a strategic approach to achieve them. Jacobus recommends “The Physician Driven Approach.” This approach should involve all clinical departments and medical specialties. Creating physician leadership and oversight is crucial to quality directed physician documentation, appropriate order set development, practical workflow redesign efforts, and effective communications. One of the best ways to create structure around this physician leadership and oversight is to create a Physician Advisory Committee (PAC).
A PAC is a high-ranking clinical committee that reports directly to the Medical Executive Committee. The formation of a physician advisory committee is a tried and tested approach to create effective physician leadership at a hospital. In general, PACs are intended to give physicians a forum for transparent communication. They provide an opportunity for physicians to be involved in the decision-making process and give hospital leadership honest feedback. The PAC should be representative of the organization’s entire clinical staff in terms of specialties, practice types, and computer literacy and serves as the central point of responsibility for the clinical aspects of the EMR system on behalf of the medical staff.
When it comes to achieving EMR ownership, PACs can be a powerful tool. Ultimately, the medical staff should “own” the EHR because they are involved in all processes in patient care across various and complex settings of care. This position makes them uniquely qualified to help facilities achieve success. Let’s discuss the process of creating an effective PAC for the purposes of achieving EMR ownership:
- Define the PAC: The PAC should function as a provider governance body within an organization that helps executive leadership to achieve regulatory, quality, and safety compliance. In terms of developing new EMR processes, the PAC serves as a rapid decision-making committee.
- Appoint a PAC chair: Jacobus recommends the committee appoint a chair that can take on the following responsibilities:
- Drive strategy
- Build consensus
- Facilitate decision making
- Delegate resources, assignments, and tasks
- Lead the EHR implementation
- Conflict resolution
- Provider champion
- Create specific work group activities: As previously mentioned, the committee should span all clinical departments and medical specialties. This diversity will ensure that the committee is equipped to handle activities across the spectrum of the EMR. We recommend the committee create work groups designed to address these activities such as CPOE and order sets, Physician documentation, EHR and workflow design, Education and training, and CDS.
- Set PAC goals and objectives: These objectives should be specific to the organization, however, it is important to remember to keep the patient’s experience and satisfaction a priority. An example of a key objective may be, “to deliver high-quality healthcare to the patients of Eastern Kentucky.” Once this main objective is defined, create the supporting goals.
- Identify potential challenges: Honestly identifying issues and potential barriers to accomplishing your organization’s goals and objectives will be beneficial in developing a plan to move forward. Not all challenges can be immediately fixed, however, it is important to at least identify and communicate them to executive leadership.
- Document medical staff current state: It’s important to get an accurate picture of what is actually happening in an organization’s current workflows and processes. This will help to identify what works well and what can be improved.
- Develop a charter outline: A charter outline helps to define the work that needs to be accomplished. It defines the roles and responsibilities of its members and addresses the current and future challenges and articulates potential solutions.
These 7 steps will allow your organization to gain almost immediate engagement from its medical staff. Early commitments to governance and clinical buy-in lay the foundation for developing key policies and guidelines to create a new future state. Ultimately, your organization will not only be able to achieve EMR ownership, but the PAC should be able to focus consistently on doing what is best for patient care.