EHR project communications and an opportunity missed.

I often sit at home during the evening I wonder how they could get it so wrong. As my father frequently says-"There's always something." The outstanding feature of the communications plan for our EHR project is that there doesn't seem to be one. It isn't as if best practices for communication in project management circles are unknown or hard to locate in publications. Ready for my short laundry list?

Icons show up suddenly in our EHR without written explanation or training on appropriate use. Single-sign on is being implemented in stages apparently. Many clinicians were never informed of this or even know what it is while others are already using badges to login to the system. I just noticed today that new hardware has been installed on the ward workstations. When I call the help desk to open a ticket for help in our EHR the request seems to go into a maw, never to be implemented or addressed. Order sets seem to be modified willy-nilly, wiping out user defined preferences and frequently removing functionality that is need for good patient care and safety. I'm just getting started but I'm relative certain that this sounds familiar to many of you.

So is there a solution? At my institution, I fear not. I have been offering my opinions about communication for over six years but I always seem to be beating my head against a brick wall. The best way to address this problem is to begin at the beginning. Every HIT project should have a well-defined communication plan. The plan should follow SMART principles. Multiple stakeholders should be considered in creating the plan and their input should be incorporated into the design. Communication should be bi-directional, comprehensive, and utilize multiple modalities to distribute important information. Finally, this should be a written plan that is periodically updated as communication needs and technology change.

By the way, last month we passed an important milestone-one year since the EHR went live. One might have expected a major celebration for this substantial achievement. Instead, there was almost no discussion of the event by administration, hospital staff, clinicians, or the community. I think this was an opportunity lost.