Daniel O'Connor, RN, was something you don't see every day – a CIO who also was a nurse. As a result, he has a unique perspective when it comes to the issue of involving clinicians in health IT – a subject of great interest to him.

O'Connor is vice president of client experience at HCTec, a health IT staffing and managed services company. Previously, he was vice president at Stoltenburg Consulting, CIO at United Memorial Medical Center, and manager of clinical information systems at University of Rochester Medical Center.

We interviewed O'Connor and talked about what it was like being a CIO who was a nurse, why he feels it is so important to have clinicians involved on health IT teams, differences between having physicians versus nurses involved on IT teams, best practices for involving clinicians in help desk support, and tips on how CIOs who want to formally hire a physician or nurse for their IT team can cost-justify these expensive clinicians.

Q. What was it like being a CIO who was a nurse? How did your clinical background inform your IT decision making?

A. Understanding the IT nuances and challenges within any operations of health systems requires a deep understanding of technology. However, it is equally vital to understand what is going on within the facilities you are serving on a day-to-day level, and all the nuances that staff experience and their IT needs.

Being a CIO with a nursing background has given me and my organization clarity about what these systems need and how they need support. As an RN, I understand the need for quick responses and resolutions that bring perspective and a true understanding of the clinicians' needs communicated to them on the same level.

Advocating for your system by bringing clinicians onto IT teams brings clinical insight, empathy and practical knowledge that significantly informs and enhances IT decision-making. This unique perspective ensures technology implementations align with clinical practice, leading to better patient care, higher satisfaction among healthcare providers and more successful IT initiatives.

Q. Why do you feel it is so important to have clinicians involved on health IT teams? How can they impact things like implementation, training, application support, service desks, etc.?

A. Clinicians bring insights, expertise and credibility to health IT teams. Their involvement ensures systems are practical and supportive of clinical workflows and patient care. By being involved in implementation, training, support and service desk operations, clinicians help maximize the effectiveness and efficiency of EHR investments, ultimately leading to better patient outcomes and higher provider satisfaction.

Involving them in every aspect of the EHR is important throughout system development, implementation, upgrades and help desk support. You only have one shot to get it right during new system implementations or major upgrades. If you don't succeed on the first try, providers will question the investment and adoption will lag.

Having people who understand the processes and how the providers engage with the EHR across every use case is vital to its success. For example, peer-to-peer support is especially important when you bring a system live. Go-live experiences bake into providers' perspectives of a system. And as new residents and providers come in, experienced clinicians serve as seasoned champions to assist clinicians with usability and workflow.

Q. Are there differences between having physicians versus nurses involved on IT teams? If so, what are they, and what does each bring to the table?

A. Yes, there are nuances to clinical peer-to-peer support for each profession. Each group brings unique perspectives, expertise and strengths that can significantly benefit health IT systems' development, implementation and support. For example, nurses have totally different workflows and ways of documenting. Nurses need to be involved in both teaching and supporting peers as they bring up the system and support it over time.

Nursing documentation requirements: Must have good order entry pathways and the ability to easily access order groups based on patient problems. Correlating information should be pushed to the clinician to expedite work. In addition, integration with telemetry and all the other data-collecting systems expedites nursing documentation.

Providers' time is harder to get. IT teams must be fully prepared and use physician and nurse time effectively. Efficiency is another valuable strategy to garner continued support from them. Both are equally important given the differences in how they practice.

By leveraging the strengths of both physicians and nurses, healthcare organizations can create more effective, efficient and user-centered health IT systems that ultimately lead to better patient outcomes and higher satisfaction among both physicians and nurses.

Q. What are your best practices for involving clinicians in help desk support, and why are they important here?

A. Include clinicians on teams to ensure end users can access a broad group of experts who understand how the EHR is used in various clinical scenarios. Be sure whether doing so internally or leveraging outside support, you are striving for the highest customer satisfaction rating and know what it takes to maintain them.

Clinicians want EHR problems solved as quickly as possible. Whether the person calling is a care tech, nurse or clinician, patient care is priority No. 1. The criticality of the acute care environment must be recognized.

Use metrics that involve two criteria:

1. Are we able to help clinical end users?

2. Are we able to do it in a way that is helpful, understanding and supportive when they are calling already upset?

If you are leveraging third-party support services, be sure its model mirrors how a health system provides its support services. For example, don't use people and services from other industries or environments. Support teams must be staffed by people who understand and are passionate about healthcare.

Q. Any tips on how CIOs who want to formally hire a physician or nurse for their IT team can cost-justify these expensive clinicians?

A. By presenting clear, data-driven arguments and aligning clinician involvement with organizational goals, CIOs can effectively cost-justify the hiring of physicians or nurses for their IT teams. These clinicians bring expertise that can lead to significant improvements in clinical outcomes, operational efficiency and financial performance.

To further justify this important investment, be sure to show the value that IT nurses and clinicians can have in the language of your CFO. It is always important to build in an ROI model with hard numbers and cost/benefit scenarios in both ways – with and without these experts on the IT team. Show what a quality support model will do to the bottom line with both tangible and intangible impacts.

Additionally, don't be shy about talking about numbers upfront. Frame nurses and clinicians joining the IT team as an investment, not as a cost.

Follow Bill's HIT coverage on LinkedIn: Bill Siwicki
Email him: bsiwicki@himss.org
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