2018-11-25

Resisters, Minimalists, Partialists, Partners and Exemplars

The Alberta Health Services (AHS) Connect Care clinical information system (CIS) can facilitate rapid access to health information across the continuum of care. However, the CIS cannot serve if it is not used consistently and effectively by all who share in care. Indeed, the legal record of care is vulnerable to inconsistent or ineffective CIS use. With Wave 1 implementation looming, it is important to anticipate prescriber engagement, adoption and CIS-use patterns.

Inevitably, a few physicians will object to CIS adoption. Whether motivated by principle, workflow concerns, ability or other reasons, the effect will be accept little interaction with the Connect Care record. These ‘resisters’ could be beyond the reach of essential communication, collaboration, decision support and care planning tools.

Other ‘minimalist’ clinicians will do only those CIS tasks absolutely essential to close encounters. Incomplete work on problem lists, medications, allergies, documentation and orders will shift information burdens to others.

Closely related ‘partialist’ phenotypes will use essential CIS features but miss all the efficiency gains to be had from personalization workshops and optimization services.

CIS ‘partners’ will use the CIS safely and collaboratively, while also enjoying decreased information burdens, increased satisfaction and generally improved clinical performance. They will seek and master the personalizations and automations made available through the system.

Finally, CIS ‘exemplars’ will not only master the CIS but additionally develop personalizations and automations to share with colleagues, and so raise the capacity of their clinical community.

As we get ready for CIS testing, training, and implementation, the time is right to look around (and within) to anticipate clinician reactions to Connect Care. We’ll need to manage to these reactions to have any hope of helpful adaptation to massive changes in the clinical workplace.

Backgrounder: Connect Care Prescriber Compliance