Latest / Becker’s Healthcare Podcast / People First: What Psychiatry Taught Me About EHR Go-Lives

Transcript

People First: What Psychiatry Taught Me About EHR Go-Lives · Becker’s Healthcare Podcast

• 0:00
  - Hello, everyone. Thank you so much for tuning
• 0:02
  - in to the Becker's Healthcare podcast series.
• 0:04
  - Today, we're going to talk about what psychiatry
• 0:07
  - teaches us about EHR go lives.
• 0:10
  - Joining us for today's conversation
• 0:12
  - is doctor Rhiannon Doherty, director of usability and
• 0:15
  - clinical optimization
• 0:16
  - at Baptist Health, and doctor Stephanie Lahr, chief
• 0:20
  - medical officer at UPerform.
• 0:22
  - Thank you both for being here today. I
• 0:24
  - will now turn things over to doctor Lahr
• 0:26
  - to get us started.
• 0:27
  - Hello, everyone. Thanks for joining us. Really excited
• 0:30
  - for this conversation with Rhiannon today.
• 0:33
  - You know, this conversation is really what it
• 0:35
  - comes down to. It's about
• 0:37
  - putting people
• 0:38
  - before the technology,
• 0:39
  - and I think, as an informaticist
• 0:42
  - myself,
• 0:43
  - there's always something to be learned in that
• 0:45
  - space. So excited to dig in and and
• 0:48
  - have this conversation
• 0:49
  - with a person who truly is an expert
• 0:52
  - in both. So Rhiannon, welcome. Tell us about
• 0:55
  - yourself, your background, the role you're in now,
• 0:59
  - and the perspective you bring to clinical informatics
• 1:02
  - and training change management.
• 1:04
  - Sure. I appreciate you having me today,
• 1:06
  - and pleased that maybe my
• 1:09
  - dual life or my multiple hats will provide
• 1:11
  - some perspective for others. So I am a
• 1:13
  - clinician first. I am a psychiatric nurse practitioner,
• 1:17
  - by training, and I do still see patients.
• 1:19
  - But I'm also the doctor of usability and
• 1:20
  - clinical optimization at Baptist Jacksonville
• 1:23
  - in Florida. And, really, my work sits in
• 1:26
  - between those spaces,
• 1:27
  - Partly clinical care, but it's also how we,
• 1:29
  - you know, informatics itself, right, that translation work.
• 1:33
  - I do work with design and consulting with
• 1:35
  - build teams, and a lot of it is
• 1:38
  - change management and how we implement the technology
• 1:41
  - we've designed.
• 1:42
  - Big picture, my job is what's the clinical
• 1:44
  - experience or what's the user experience of delivering
• 1:47
  - care or supporting care? How do we reduce
• 1:49
  - that friction so that the tools that we've
• 1:52
  - made support the work and don't become more
• 1:54
  - work?
• 1:55
  - In terms of how I got here, I
• 1:57
  - I never meant to get into digital health
• 1:59
  - care.
• 2:00
  - That was not my original intent. I meant
• 2:01
  - to just go into clinical care. Think like
• 2:03
  - a lot of informatics, it's we fall into
• 2:05
  - it.
• 2:06
  - Really, I was sitting and I was seeing
• 2:07
  - patients. My specialty area is
• 2:10
  - complex unresolved adult trauma. It takes it's very
• 2:13
  - intense work. And I realized I was busy
• 2:16
  - clacking on the keys and not making eye
• 2:18
  - contact with my patients in their most vulnerable
• 2:20
  - moments,
• 2:21
  - and that
• 2:22
  - all I could think is this computer was
• 2:24
  - supposed to be my tools, was to aid
• 2:25
  - me in this work, and really it started
• 2:27
  - feeling like a barrier.
• 2:28
  - And so I that inspired me to get
• 2:30
  - in that space in between and to help
• 2:32
  - transform it.
• 2:33
  - I knew we could do better, and I
• 2:35
  - still believe we can continue to grow and
• 2:37
  - do better in that space.
• 2:39
  - I'm at the front line.
• 2:40
  - I'm also in the space in between. I
• 2:42
  - really like
• 2:43
  - the process of taking big picture enterprise strategy
• 2:46
  - and need,
• 2:48
  - operationalizing that, and then transforming what it feels
• 2:50
  - like to use the technology
• 2:52
  - we offer.
• 2:54
  - Yeah. I I love your story. I I
• 2:56
  - agree with you. I think,
• 2:58
  - a lot of
• 2:59
  - informaticists,
• 3:01
  - certainly for myself
• 3:03
  - also kind of fell into it because
• 3:06
  - things weren't quite the way they they needed
• 3:08
  - to be, and yet I felt, well, I
• 3:10
  - could stand on the sidelines and complain about
• 3:12
  - it, but that's not gonna be very impactful.
• 3:14
  - So instead, why don't I roll up my
• 3:17
  - sleeves and and bring the skill sets that
• 3:18
  - I have
• 3:19
  - forward? And and your background is,
• 3:22
  - very
• 3:23
  - uniquely, you know, sort of aligned with this
• 3:26
  - ability to bring the human experience
• 3:29
  - together because some of your specific training in
• 3:31
  - your in your clinical background
• 3:33
  - aligns with that.
• 3:35
  - I heard you talk about this sort of
• 3:38
  - humanistic
• 3:39
  - philosophy
• 3:40
  - of, you know, design work,
• 3:43
  - and that might be something that people aren't
• 3:46
  - as familiar with as they think about, informatics.
• 3:49
  - And it sounds cool, but it's like, what
• 3:52
  - what does that really mean? So maybe
• 3:54
  - break that down a little bit and and
• 3:56
  - talk a little bit more about how your
• 3:58
  - psychiatric
• 3:59
  - background,
• 4:01
  - blends every day into informing the way you
• 4:03
  - think about training, adoption, and change communication.
• 4:07
  - Sure. Yeah. Humanistic sounds like something from, like,
• 4:09
  - freshman year gen ed philosophy requirements. Right? It
• 4:13
  - doesn't sound something we think we can use
• 4:14
  - every day.
• 4:16
  - So psychiatry and mental health work in general
• 4:18
  - teaches you pretty quickly.
• 4:20
  - Just because,
• 4:21
  - you've told someone something, that doesn't mean they're
• 4:23
  - going to do it. And, they're not just
• 4:26
  - gonna change because you told them it's a
• 4:27
  - good idea. A lot of our work is
• 4:29
  - change management on the individual level. Right? But
• 4:32
  - that can be applied just as much to
• 4:34
  - the organizational
• 4:35
  - level, and the philosophies are still quite similar.
• 4:38
  - We often approach our our go lives and
• 4:40
  - implementations
• 4:41
  - as
• 4:42
  - knowledge deficits. That if we just give people
• 4:45
  - the right tip sheet, the right website, the
• 4:47
  - right email,
• 4:48
  - the right elearning,
• 4:50
  - that they they're gonna have the knowledge and
• 4:51
  - be ready to go when the day hits.
• 4:53
  - But
• 4:54
  - people need so much more to embrace change.
• 4:58
  - And I think anyone who's ever had to
• 4:59
  - go through significant changes in their life knows
• 5:01
  - that.
• 5:02
  - They need to feel like they're going to
• 5:04
  - succeed before they even get started.
• 5:07
  - They need to also feel like they have
• 5:08
  - a sense of control.
• 5:10
  - And if they can't control the process, they
• 5:12
  - at least need to know what parts they
• 5:13
  - can or cannot be impacted by and how
• 5:15
  - they're gonna be able to control those pieces.
• 5:17
  - They also need to feel that the person
• 5:19
  - leading that change, if it's not self imposed
• 5:21
  - change, that they understand where they're coming from,
• 5:24
  - and in this case, understand the reality of
• 5:25
  - the work.
• 5:26
  - And and so this all ties back to
• 5:29
  - we use, there's a self determination theory in
• 5:31
  - psych we use a lot, and it's about
• 5:33
  - autonomy,
• 5:35
  - competence,
• 5:36
  - and connection.
• 5:37
  - And we know that all three of those
• 5:39
  - things can go really awry in an implementation.
• 5:42
  - Somebody may not be confident in workflow,
• 5:44
  - base level. Right?
• 5:46
  - But they also may feel disconnected from the
• 5:48
  - project
• 5:49
  - or not know where to take those concerns.
• 5:51
  - And and then they just might feel
• 5:54
  - their needs aren't being met in the process.
• 5:57
  - So they have no control. They have no
• 5:59
  - say. They're at the mercy of another system,
• 6:01
  - and no one embraces change in that.
• 6:04
  - And in fact, I would say I mean,
• 6:06
  - I feel like those three elements
• 6:09
  - without them also are often what we hear
• 6:11
  - about leading to burnout.
• 6:13
  - Right? So it's the whole continuum
• 6:16
  - of it's not really even just a matter
• 6:19
  - of whether you get the adoption
• 6:21
  - and the execution of, you know, the ROI
• 6:24
  - on on the technology,
• 6:25
  - but really if that change management
• 6:28
  - isn't
• 6:29
  - done appropriately,
• 6:30
  - if you don't have clinicians with autonomy,
• 6:34
  - confidence,
• 6:35
  - and connection,
• 6:36
  - that will lead to burnout, not just the
• 6:38
  - failure of your project. So hugely important.
• 6:42
  - When I do more academically sort of aligned
• 6:44
  - research,
• 6:45
  - that's my area of interest is clinical documentation
• 6:48
  - burden. And I know we we all believe
• 6:50
  - AI right now is is gonna some people
• 6:52
  - believe anyway that it's a silver bullet. Right?
• 6:55
  - It introduces other types of frictions as well.
• 6:58
  - And and we need to be really intentional
• 7:00
  - with our technology choices
• 7:02
  - and have all the right people at the
• 7:04
  - table participating in those discussions,
• 7:07
  - not just the people who are your your
• 7:08
  - your tech friendly tech forward folks who get
• 7:10
  - the newest iPhone and really wanna be on
• 7:12
  - that AI implementation team, but the folks who
• 7:15
  - are really reluctant as well because
• 7:18
  - we view resistance as a bad thing,
• 7:20
  - but good designers and folks in psychiatry know
• 7:23
  - that it's a signal. They know that that's
• 7:25
  - a sign that something else is going on,
• 7:27
  - either a thought process
• 7:28
  - or a barrier to, you know,
• 7:31
  - a success somehow, and they get curious about
• 7:33
  - it. And I think that's also what psychiatry
• 7:35
  - has gifted me is is the ability to
• 7:38
  - reframe a situation,
• 7:40
  - be more objective, and just get curious about,
• 7:42
  - oh, why aren't they using this great new
• 7:44
  - tool we created
• 7:45
  - without judging that and, taking a person like,
• 7:48
  - because when you've been vet as as an
• 7:50
  - IS person, right, as a person who builds
• 7:52
  - things, I'm a physician builder with Epic,
• 7:54
  - I built something glorious, I think. I said
• 7:57
  - forty hours in that programming or something, and
• 7:59
  - then someone just turns it down or they
• 8:01
  - don't like that one button isn't the right
• 8:03
  - color.
• 8:04
  - But that speaks to a deeper issue. What
• 8:06
  - didn't I hear about their process and their
• 8:09
  - experience that I didn't incorporate?
• 8:11
  - And so you have to learn to be
• 8:12
  - curious and not take it so personally.
• 8:14
  - Yeah. I love that. Well, let's dig in
• 8:17
  - and talk about a particular
• 8:19
  - project where you brought all of this together.
• 8:22
  - At Baptist Jacksonville, you guys had a really
• 8:25
  - big undertaking. You transitioned,
• 8:28
  - from a previous communication platform
• 8:31
  - to Epic Secure Chat,
• 8:33
  - and, certainly, you know, communication is
• 8:36
  - essential
• 8:37
  - to the quality and,
• 8:40
  - and delivery of of good care. So it's
• 8:43
  - a high stakes scenario. It's not just talking
• 8:46
  - about, oh, well, it's okay. It's, it's just
• 8:49
  - some, some chatting here and there. Really care
• 8:51
  - decisions and,
• 8:53
  - the, the continuum of care is built on
• 8:57
  - the ability for teens to be able to
• 8:58
  - communicate, and when that communication breaks down,
• 9:01
  - we run into challenges that go all the
• 9:03
  - way to the level of the patient. So
• 9:05
  - how did you take this approach
• 9:08
  - of,
• 9:08
  - this humanistic philosophy and design
• 9:11
  - into that practice in this, you know, really
• 9:14
  - important
• 9:16
  - and and high stakes,
• 9:18
  - transition that was happening at Baptist.
• 9:21
  - Sure. Yeah. No. It's it was a great
• 9:22
  - project. It went it went really well, which,
• 9:24
  - you know, I can start from the good
• 9:26
  - space. Right? And and switching to SecureChat, like
• 9:28
  - you said, wasn't like sending text messages to
• 9:30
  - your friends. You're doing it for fun. It
• 9:31
  - it it could be things like critical lab
• 9:33
  - values that needed to be acted on immediately
• 9:36
  - that we really needed to to treat with
• 9:37
  - the utmost seriousness.
• 9:39
  - And there's a lot of tethers in the
• 9:41
  - background. So secure chat wasn't just changing your
• 9:43
  - messaging time. It was changing how we scheduled.
• 9:46
  - It was changing how consoles got routed, which
• 9:48
  - can get really complicated,
• 9:50
  - and and actually how you find on who's
• 9:52
  - on call even. So who am I supposed
• 9:54
  - to talk to about this? Transformed all that.
• 9:56
  - And like you said, it was high stakes
• 9:58
  - workflows. It was things like critical care or
• 9:59
  - I need a
• 10:01
  - that consult for this. And we needed that
• 10:03
  - to get to the right person, whether that
• 10:05
  - was the resident or the attending, whether that
• 10:07
  - was the APP or the physician. And it
• 10:09
  - had to get to the right person the
• 10:11
  - first time quickly.
• 10:12
  - The first step,
• 10:13
  - as I said earlier, bringing people to the
• 10:15
  - table, the first step was to understand the
• 10:17
  - workflows itself.
• 10:19
  - Rather than come at it from a
• 10:21
  - a product perspective or platform perspective, we need
• 10:24
  - to start with what is the job we're
• 10:26
  - trying to accomplish
• 10:27
  - because it's gonna vary space to space, role
• 10:29
  - to role.
• 10:30
  - You know, there it's not one way to
• 10:32
  - use secure chat. And so we had to
• 10:35
  - look at what was gonna be familiar
• 10:38
  - about the the new process,
• 10:40
  - what was really gonna be a gap, and
• 10:41
  - were there functionality differences? Because in consult routing,
• 10:44
  - we found that there were. And what are
• 10:46
  - we gonna do about that
• 10:47
  - proactively
• 10:48
  - so that we don't have to react poorly.
• 10:51
  - I also
• 10:52
  - always encourage people to think about
• 10:54
  - what what gives you pause, have a user
• 10:57
  - go through the workflow, play test it.
• 10:59
  - Where are they uncertain?
• 11:01
  - And and if you can watch them when
• 11:03
  - they're going through that work, it's an often
• 11:04
  - usability exercise. Right? They have a moment and
• 11:07
  - go, hey. You seem like you had to
• 11:08
  - to figure out where to go from there.
• 11:10
  - Where did you want to go?
• 11:12
  - Because if we have control over the the
• 11:14
  - the user interface
• 11:15
  - as much as we do, you can make
• 11:17
  - it an intuitive choice based on what they
• 11:19
  - need and what they're trying to accomplish.
• 11:22
  - Again, it came back to you, them understanding
• 11:24
  - why we needed a change in the first
• 11:25
  - place. Just because somebody's told you it's happening,
• 11:28
  - doesn't mean you appreciate the why. And so
• 11:30
  - I think we we did a pretty good
• 11:32
  - job of
• 11:33
  - tying it to our larger mission, tying it
• 11:36
  - back to serving the community. This was gonna
• 11:38
  - help us connect to each other, connect to
• 11:40
  - the care we're delivering, and also be more
• 11:43
  - actively managing with the patient and the and
• 11:45
  - the family members that they care for. It
• 11:47
  - it actually is a very expansive platform.
• 11:50
  - Within this project, I definitely hear that it
• 11:52
  - was
• 11:53
  - as much about
• 11:54
  - communication,
• 11:56
  - as it was about
• 11:58
  - training. Here's where to go and, you know,
• 12:00
  - this is what the tool how the tool
• 12:01
  - works.
• 12:02
  - What were the mechanisms that you use to
• 12:05
  - effectively support
• 12:07
  - communication
• 12:07
  - for busy clinicians who we know often are
• 12:10
  - not gonna look at an email and where
• 12:12
  - part of what you were doing was rolling
• 12:14
  - out a new communication platform,
• 12:16
  - So there's some irony in, like, you know,
• 12:18
  - you've you've already got opportunity to improve communication.
• 12:22
  - What were the tools that you were using
• 12:24
  - to
• 12:25
  - even get that word out?
• 12:27
  - Yeah. I mean, we did obviously, email's kind
• 12:29
  - of the the mainstay. Right? For some reason.
• 12:32
  - One email
• 12:33
  - wasn't gonna do it. Just telling people, hey.
• 12:35
  - There's there's change coming. Make sure you do
• 12:37
  - your e learning. And especially
• 12:40
  - even multiple messages, if it was saying the
• 12:42
  - same thing over and over, wasn't going
• 12:45
  - to sit right. Right? It wasn't gonna give
• 12:47
  - them the right information at the right time.
• 12:48
  - Just like clinical decision support, it needs to
• 12:50
  - do the right information at the right time
• 12:52
  - in the right way to the right person.
• 12:54
  - And clinicians receive and users receive a tremendous
• 12:57
  - amount of information just in their own lives
• 12:59
  - and at work. And so we we didn't
• 13:01
  - wanna contribute to
• 13:03
  - them being overwhelmed with too much information either.
• 13:06
  - So we really take that philosophy of
• 13:09
  - how do we connect people to the information,
• 13:12
  - how do we get them confident enough
• 13:15
  - in the moment when they need it, and
• 13:17
  - then how do we give them the resources
• 13:19
  - to determine their own path going forward. And
• 13:21
  - what we found was so we how do
• 13:23
  - you perform,
• 13:24
  - we use we call it knowledge now, And
• 13:26
  - we use learning pathways, which are something like
• 13:29
  - a website
• 13:30
  - that have, custom
• 13:32
  - subpages on them, but it allows for one
• 13:35
  - source of truth.
• 13:37
  - And we, tied that in with some custom
• 13:40
  - branding so people knew what they were looking
• 13:42
  - at. They knew where it was coming from.
• 13:44
  - We had a a slogan on it that
• 13:46
  - tied in our sub message that tied it
• 13:47
  - to the mission.
• 13:48
  - And then those buckets weren't what we thought
• 13:51
  - were important.
• 13:52
  - The buckets were the workflows that we thought
• 13:54
  - people were trying to achieve.
• 13:56
  - And so we reframed the entire pathway to
• 13:59
  - look like, how do I find the answer
• 14:01
  - to the question I have right now? And
• 14:02
  - it started with the highest level,
• 14:04
  - what even is secure chat,
• 14:07
  - all the way down
• 14:08
  - to the most detailed workflow tools, but it
• 14:10
  - was all one source. And so it allowed
• 14:12
  - people to dig, get contacts to go live,
• 14:15
  - but the same source was just their truth
• 14:17
  - later when they had more detailed questions or
• 14:19
  - ran up into that barrier, that friction. That
• 14:21
  - was really important
• 14:23
  - whether we send it through,
• 14:25
  - a tip sheet or a flyer on the
• 14:26
  - wall. It didn't matter. It pointed people at
• 14:28
  - that same trusted source of truth.
• 14:31
  - Yeah. I love that. I mean, clearly, this
• 14:33
  - was a multidisciplinary
• 14:35
  - project
• 14:37
  - crossing so many parts of the organization.
• 14:39
  - You've talked a little bit about this, but
• 14:41
  - maybe just, you know, for those who may
• 14:43
  - be planning a project like this and thinking
• 14:45
  - about the steps that they need to go
• 14:47
  - through, just spend a minute talking a little
• 14:49
  - bit about who was at the table and
• 14:52
  - when, and then we can talk about the
• 14:54
  - sort of the retrospective
• 14:55
  - scope and and how things went and what
• 14:57
  - you might have done differently.
• 14:59
  - Yeah.
• 15:01
  - So
• 15:02
  - one thing we do differently that I I
• 15:05
  - since coming to Baptist, I really love about
• 15:06
  - how we handle things is
• 15:08
  - no one wants to stick in in a
• 15:10
  - very large kickoff meeting. However,
• 15:13
  - bringing people that you might think you need
• 15:15
  - at the end of the process into it
• 15:16
  - at the beginning
• 15:18
  - can really help not only with buy in
• 15:19
  - and adoption,
• 15:21
  - but they might be able to pick out
• 15:22
  - flaws in your plan or, your design way
• 15:26
  - ahead before you've spent twenty hours crafting the
• 15:29
  - great solution you thought you had.
• 15:31
  - And that includes folks like super users. So
• 15:33
  - these are our end users without technical training.
• 15:35
  - It also includes folks like our training team.
• 15:38
  - Yes. We think about, oh, I don't need
• 15:39
  - them till I need my tip sheet. I'm
• 15:41
  - gonna wait till it's built. But they're also
• 15:43
  - the people who know what the workflow is
• 15:46
  - and how much of a gap there's going
• 15:47
  - to be
• 15:48
  - in what there's going to be coming down
• 15:51
  - the pike. Right? And they can help fill
• 15:52
  - those spaces.
• 15:54
  - That also pulls in our our CI folks,
• 15:56
  - our clinical informaticists
• 15:57
  - who know the workflows as they should be,
• 15:58
  - you know, how much of a lift it's
• 16:00
  - gonna be to change that behavior.
• 16:02
  - They also know the knock on effects. What's
• 16:04
  - the regulatory on that? What's the compliance? What's
• 16:06
  - our policy?
• 16:08
  - But really the folks who led the charge
• 16:09
  - it wasn't my team. I support the platform.
• 16:12
  - The folks who led the charge was our
• 16:13
  - clinical transformation team.
• 16:15
  - They got into the weeds with every role,
• 16:19
  - every stakeholder, every work group, which were both
• 16:22
  - internal and external.
• 16:23
  - We couldn't have overestimated how much time that
• 16:26
  - was gonna take, and the level of things
• 16:28
  - we discovered that we didn't realize the former
• 16:30
  - platform was doing, we're like, oh, that's how
• 16:32
  - they're using it. That was a surprise. We're
• 16:34
  - gonna need to work around that. We only
• 16:36
  - did that proactively because those folks were at
• 16:38
  - the table to ask those questions.
• 16:40
  - So
• 16:41
  - although you don't want a very crowded meeting
• 16:42
  - in the beginning, having the right people
• 16:45
  - at least be aware of the movement of
• 16:47
  - the project at a high level can help
• 16:49
  - you avoid mistakes later. And then there was
• 16:51
  - our frontline clinicians.
• 16:53
  - We we need them for feedback, and that
• 16:55
  - comes through our super users for the most
• 16:57
  - part. But they're gonna let us know,
• 17:00
  - where the friction is early on so we
• 17:02
  - can get ahead of it before people start
• 17:04
  - going, this tool is useless and for getting
• 17:06
  - very frustrated with it. So
• 17:09
  - Yeah. I think your point about, you know,
• 17:11
  - balancing
• 17:12
  - a meeting that's too big and, you know,
• 17:14
  - people worry not only about the ability to
• 17:16
  - run the meeting, but also
• 17:18
  - the resources. If you look at a room
• 17:20
  - full of 40 people and you start counting
• 17:22
  - up the dollars, you think to yourself, wow,
• 17:24
  - we're spending a tremendous amount of money right
• 17:26
  - now with all of these people in the
• 17:27
  - room, and most of them are just sitting
• 17:29
  - around and listening. Is there value in that?
• 17:31
  - Is that the investment that is was worthwhile?
• 17:34
  - And what I
• 17:36
  - think is clear in what you've articulated is
• 17:39
  - it's an investment
• 17:41
  - that you're making upfront
• 17:43
  - to avoid
• 17:45
  - rework dollars later because those Yep. Same people
• 17:48
  - will be engaged later in the process,
• 17:51
  - and it is more likely that you'll, you
• 17:53
  - know again, if we wanna break it down
• 17:55
  - to dollars and cents,
• 17:57
  - spend twice the amount of resource,
• 17:59
  - twice the amount of time, twice, you know,
• 18:01
  - whatever
• 18:02
  - going back and reworking
• 18:04
  - then if you can bring them in at
• 18:06
  - the beginning. And so while it may
• 18:08
  - feel
• 18:10
  - over overdone,
• 18:12
  - it probably is the most efficient way to
• 18:14
  - do it as long as you can run
• 18:16
  - the meeting well. And like you say, you
• 18:18
  - can if you've set the stage in that
• 18:20
  - large scale environment,
• 18:22
  - you don't keep that. It's not that's not
• 18:24
  - the project team for the duration,
• 18:26
  - but it allows everyone to know so that
• 18:28
  - when you start to break it into parts,
• 18:31
  - everyone started from from the same,
• 18:34
  - sort of initial understanding
• 18:36
  - and and ability to to create questions and
• 18:39
  - participate. I I really think it's a great,
• 18:41
  - great point.
• 18:42
  - And I would add, and this sort of
• 18:44
  - comes back to that soft skill perspective, we'll
• 18:47
  - say.
• 18:48
  - It's it's not just about
• 18:50
  - what mistakes are we avoiding later.
• 18:52
  - It's about
• 18:54
  - the credibility
• 18:55
  - the effort gets because the people are at
• 18:57
  - the table and hearing it. They feel engaged
• 18:59
  - and involved in the beginning, therefore, respected.
• 19:02
  - And so if we start getting the people
• 19:05
  - they respect and admire
• 19:07
  - involved early,
• 19:09
  - we're gleaning a lot of good morale,
• 19:12
  - possibly even buzz towards an effort that that's
• 19:16
  - asking people to sacrifice what they know how
• 19:18
  - to do right now. They're comfy with what
• 19:19
  - they're doing. It may not be perfect.
• 19:22
  - That is a sacrifice on their part. And
• 19:23
  - so you need to engender it's almost like
• 19:25
  - a bank deposit. Right? You need to deposit
• 19:27
  - if you're gonna withdraw.
• 19:29
  - Need a deposit
• 19:30
  - respect and trust and
• 19:33
  - the desire to understand perspective
• 19:36
  - before you draw on that to make the
• 19:38
  - change itself.
• 19:40
  - Yeah. That's an amazing quote. I love it.
• 19:43
  - So project completes.
• 19:45
  - You look back.
• 19:47
  - Tell us about, you know, how the how
• 19:49
  - the go live performed, what stood out to
• 19:52
  - you,
• 19:53
  - and what were the moments that you were
• 19:55
  - really proud that the approach that you took,
• 19:57
  - you could you could see it coming together?
• 20:01
  - Yeah. I mean, obviously, there was our our
• 20:02
  - first what were the numbers, like, what did
• 20:04
  - we get,
• 20:05
  - in the beginning. What really makes me proud
• 20:08
  - is is what happened after the fact, actually.
• 20:10
  - But to to put it in some context,
• 20:12
  - so when the secure chat pathway, this one
• 20:14
  - site, the subsides went live, we got about
• 20:16
  - 9,000 views initially.
• 20:19
  - It was great. Wow. And it was about
• 20:20
  - 1,600
• 20:22
  - unique users. So we're not only looking at
• 20:24
  - times they're clicking, and that shows obviously those
• 20:26
  - 1,600 people are going back and clicking multiple
• 20:29
  - times. So it's a resource worth going back
• 20:31
  - to for one.
• 20:33
  - But it also we wanted to look at
• 20:35
  - was it reaching the right people, and we
• 20:37
  - could with UPerforms platform, we could do that
• 20:38
  - with the analytics. We could see which roles,
• 20:41
  - which departments, what groups are they in, which
• 20:43
  - cohorts are signing in, which ones aren't,
• 20:45
  - and did we miss something. And so we
• 20:47
  - can be proactive in making sure we've got
• 20:49
  - all the stakeholders on board.
• 20:51
  - But
• 20:52
  - they also we watched our search queries.
• 20:55
  - What were people searching for that involves secure
• 20:57
  - chat? Spelled correctly or not
• 20:59
  - and or just chat or messaging or we
• 21:02
  - we use this sort of synonyms. Right? 80%
• 21:05
  - of those people with the platform, the it
• 21:07
  - has this AI enabled search answer, so it
• 21:10
  - gives them, a direct answer experience that you
• 21:12
  - get, like, on Google. Right? 80% of their
• 21:15
  - questions got direct answers just from the materials
• 21:17
  - we already gave them. They didn't have to
• 21:18
  - go any deeper. They had their questions answered
• 21:20
  - immediately. But if they wanted to, that principle
• 21:23
  - of give them the context and they'll keep
• 21:26
  - going when they need it was
• 21:28
  - 60%
• 21:29
  - clicked through.
• 21:30
  - Right? We talk a lot about in social
• 21:32
  - media on click through rates. I'm like, do
• 21:33
  - they engage?
• 21:35
  - Right. 60%
• 21:37
  - film the materials
• 21:38
  - worthwhile enough that they went they kept going
• 21:40
  - further into it. And that was really important.
• 21:42
  - What did we actually see for secure chat
• 21:44
  - usage is also probably something on people's minds.
• 21:46
  - We had
• 21:48
  - essentially a million
• 21:50
  - usage of secure chat in July alone.
• 21:53
  - Wow.
• 21:54
  - Yeah. About 30% was nursing, but 20%
• 21:58
  - was our provider population.
• 22:00
  - The rest is a mix. It could be
• 22:01
  - transport. It could be EBS,
• 22:04
  - telemonitoring.
• 22:05
  - But we have really good engagement. A million
• 22:07
  - usage in in just a month.
• 22:09
  - Yeah. And I'm assuming that that's it's probably
• 22:12
  - something that you're even seeing trend up. Right?
• 22:15
  - It's like it because people are thinking of
• 22:17
  - other ways. Oh, I could probably use it
• 22:19
  - for this. That's how you also know you're
• 22:20
  - getting
• 22:21
  - traction and adoption is when people
• 22:24
  - use the tool the way that you intended
• 22:27
  - them to use it and then
• 22:30
  - realize
• 22:31
  - the power of it and continue
• 22:33
  - or expand
• 22:34
  - its use beyond maybe the initial things you
• 22:36
  - said you must use this for,
• 22:39
  - they adopt it because they want to use
• 22:40
  - it.
• 22:42
  - Absolutely. And we're seeing requests come in for
• 22:45
  - use cases we never would have thought of.
• 22:47
  - Users are confident enough in not only using
• 22:49
  - the tool, but are already thinking about optimizing
• 22:51
  - it for their own value. It comes back
• 22:54
  - to what they value, the workflows they're doing,
• 22:56
  - how are they bringing that to us so
• 22:58
  - that we can help the tool grow organically
• 23:00
  - in ways that suit our needs.
• 23:04
  - So as we kind of close out the
• 23:06
  - conversation,
• 23:07
  - if one last question. If you could offer
• 23:10
  - those that are listening a piece of advice,
• 23:13
  - people that are, you know, maybe informatics,
• 23:16
  - leaders,
• 23:18
  - educators, those preparing
• 23:20
  - training materials who are really, you know, deeply
• 23:22
  - embedded in this idea of how do we
• 23:25
  - get
• 23:26
  - beyond just usage
• 23:28
  - to true adoption.
• 23:31
  - What
• 23:32
  - what would that piece of advice be?
• 23:35
  - I think it's about
• 23:37
  - meeting the users where they're at,
• 23:39
  - meeting their needs
• 23:41
  - rather than the content you're trying to create
• 23:44
  - or get them to adopt.
• 23:46
  - Those are not mutually exclusive agendas. Right? But
• 23:50
  - putting the users first
• 23:52
  - by truly it's it's just like
• 23:55
  - you can't solve a problem you haven't fully
• 23:57
  - defined.
• 23:59
  - You can't serve a user you don't know.
• 24:02
  - And I feel like truly understanding the perspective
• 24:05
  - can help, and the best way to do
• 24:06
  - that is to get them involved.
• 24:08
  - We know clinicians' time and other users' time
• 24:11
  - support users' time is is valuable,
• 24:13
  - but their input is also valuable.
• 24:16
  - It is rewarding into itself when you can
• 24:18
  - create and foster those relationships with our team
• 24:21
  - members
• 24:22
  - to participate in an engaged way. We do
• 24:25
  - a lot of codesign work. And so I
• 24:27
  - think it's about just asking the question in
• 24:29
  - the first place, being curious again,
• 24:31
  - going and rounding, hearing what they have to
• 24:33
  - say, maybe not even asking, just observing
• 24:37
  - without judgment.
• 24:38
  - And then when they bring a concern, taking
• 24:40
  - it seriously.
• 24:42
  - So it's not someone complaining.
• 24:44
  - It's it's not someone venting.
• 24:46
  - It is a signal. It's a strong signal.
• 24:48
  - And if they took
• 24:50
  - the moment of vulnerability
• 24:52
  - to tell you the issue they're having,
• 24:55
  - that's designer gold. Right? And we often dismiss
• 24:59
  - it as, oh, well, they just complaining about
• 25:01
  - the new product because they don't like change.
• 25:03
  - That's an easy, lazy answer. We need to
• 25:05
  - go back, look at the resistance, be curious
• 25:08
  - about the resistance,
• 25:09
  - and ask ourselves, are we doing the right
• 25:11
  - thing? Maybe it wasn't a design issue, maybe
• 25:14
  - it's an education issue, maybe it was an
• 25:15
  - education issue, maybe it's a we didn't put
• 25:17
  - enough support in the right places. So I
• 25:19
  - think it's really about being curious and
• 25:22
  - unapologetically
• 25:22
  - human user first.
• 25:25
  - Yeah. I love it. What a great way
• 25:26
  - to end. Rhiannon, thank you so much for
• 25:29
  - sharing your insights, sharing some of the the
• 25:31
  - processes you've used, and and bringing it to
• 25:34
  - life in a in a real project that
• 25:36
  - helps people really understand
• 25:38
  - what that opportunity could look like and how
• 25:39
  - to deploy that themselves. Super helpful. Great to
• 25:42
  - see you as always.
• 25:44
  - It's a pleasure. Absolutely. Thank you for the
• 25:45
  - opportunity to share our journey.
• 25:48
  - Thank you, doctor Lahr and doctor Doherty, for
• 25:50
  - your time and insights today.
• 25:51
  - This episode was sponsored by UPerform,
• 25:54
  - a just in time learning platform that supports
• 25:57
  - the full learning life cycle
• 25:59
  - from onboarding new hires to go lives,
• 26:02
  - upgrades, and continuous optimization.
• 26:05
  - Learn more at youperform.com.