Table 7
Factors Associated with Successful Information—Representative Quotations from Interviews
| Having organizational leadership, commitment and vision | ”(The CEO) invested in it when there was very little reason to invest in it. He was way ahead of his time. When there was tremendous cost constraints and against all of his senior managers advice, including my own, he invested a lot of money in IS. Because it takes so much time to develop, especially when you are developing it for the first time, he was right on target." Physician manager |
| “When there were bumps and bruises along the way and some people questioned whether they should be doing this they would get a friendly call from (the CEO) that this is the direction we are going in and everyone is going to march in this direction." Deputy CIO | |
| “I think strong physician leadership. This has grown out of the physician community, folks who are well regarded as clinicians and as part of the group and colleagues. Chief of Medicine | |
| “You have to have leadership that has a vision of where you are going and you have to stay the course. Any time you are on the cutting edge there are going to be fresh starts and you have to be able to re-articulate the vision so people can see where it is going to lead." CEO | |
| Improving clinical processes and patient care | “My objective overall was to improve patient care. As with most facilities we struggled with having clinical information available to the physicians and practitioners at the point of contact where it was in the wards or in the clinics." CEO |
| “We are able to standardize care around best practices in a much more effective manner when it's enforced by an order entry system. It aids the physicians in terms of not being forced to remember huge amounts of choices for drugs or other clinical scenarios." Physician | |
| “Safety is a big part of quality management and once a gap is noted that could cause errors we would like to close that gap quickly and comprehensively. With paper systems it is just impossible to do that”. Physician manager | |
| Involving clinicians in design and modification of system | “We had over 530 people involved, and doctors hired to help us design screens and everything. The doctors were very much part of the effort." IT Manager |
| “We developed screens and asked for their input before we settled on a certain pathway or a certain format. We involved them as much as we could without getting bogged down in all the minutiae." Physician | |
| “We said we want any suggestions, if this thing sucks and you think it does then tell us about it. Being that open minded and being willing to go back and change things and modify it was very helpful. It showed you were interested." Physician | |
| “They didn't just wait until someone got frustrated enough with a process that they sent them an email or showed up in their office. They set up regular meetings on a weekly basis so that those who were users of the system had automatic input into the development of the system. Getting that feedback has been criti-caland responding to it also." Chief of Medicine | |
| Maintaining or improving clinical productivity | “It's easier to get the physician to the workstation if you let them do all of their work there, all of their ordering there and that's the approach that we have taken." Physician and informatics professional |
| “I think that training was one. They all had to be trained and we spent a lot of time training them, sometimes one on one. I can recall some of those who were not as quick as others we would send some trainers to spend one on one time with them." Physician | |
| “We would go out and hover in the areas, we made rounds frequently, often times we would be there before the physician, just as they were getting ready to call, we'd say `here we are.'" Nurse and informatics professional | |
| Building momentum and support amongst clinicians | “Once he convinced us we became his disciples and then all of us went out and had a meet with all the medical staff in division meetings and department meetings. We demonstrated and talked about it and evangelized the clinical staff that this was something good, something sexy, high tech and innovative and it was going to be expected to be utilized." Physician |
| “Make things work there and then it diffused and then once it starting to diffuse you jump on it and make it happen." Physician and informatics professional | |
| “You hit a point where you can't practice without being on line and we hit that momentum and it just started to run really." Deputy CIO | |
| “When we heard that there was peer pressure to get those few remaining progress notes into the computer we knew that we were there." Nurse and informatics professional |
