CMIO interview with Dr. Woodside – The Breakaway Group

CMIO Magazine: Tell me a little bit about your background and about The Breakaway Group.

Dr. Woodside: I was an undergraduate at Oregon State University and attended medical school at the University of Oregon.  After internship at Oregon, I completed a urology residency at the University of New Mexico.  I was subsequently on the faculty at the University of New Mexico and the University of Texas Medical School at Houston. In 1992, I joined the University of Tennessee College of Medicine where I practiced urology and was the CEO of UT Bowld Hospital. I became Executive VP and CMO of UT Medical Group in 1999 and joined The Breakaway Group as CMO in 2008.  

The Breakaway Group is a Denver-based consulting company founded in 2000 and has 45 employees.  We work exclusively with healthcare clients using a unique methodology to help them adopt IT technology fast.  In 2009, we were ranked in Inc. 500 as one of the fastest growing educational companies in the U.S. and the fastest growing in Colorado.

CMIO Magazine:  What key clinical projects are you working on?

Dr. Woodside: My main focus area is physician adoption of the EMR/EHR – what are the barriers and the strategies to overcome them.  We define adoption as end-users employing the EMR according to policies, procedures and best practices of the organization.  I learned first hand of the challenges of an EMR implementation through experiencing an organization’s failed implementation.  While many factors contributed, perhaps the most important was very poor physician adoption.  That experience, as well our client experience,  led to our current research. My colleague, Dr. Heather Haugen, and I decided to focus our research on physician adoption. It became apparent to us that implementation and adoption of an EMR are not synonymous, even though they are often considered the same effort in the literature.  Implementation is an event and adoption is a dynamic process that requires a sustained effort over the life of the technology.  She and I have almost completed a book, “Beyond Implementation: A Prescription for Lasting EMR Adoption,” that describes our research and a methodology for improving adoption over the long haul.  The book will be published in the next few months.  Our hope is that it will help healthcare organizations navigate the challenges of adopting an EMR – to the benefit of their patients, physicians and organization.

CMIO Magazine:  What products or services should hospitals and other providers know about The Breakaway Group but probably don’t?

Dr. Woodside: There are four components to our method.  First, we emphasize engaged leadership.  This begins at the highest level of leaders in the organization.  We explore their culture and philosophy, help them develop a vision for the project, establish a communication plan for the entire organization, and encourage them to establish appropriate stakeholder advisory groups.  Particularly important is a physician advisory group.  They must have a formal charter, a vision statement describing the benefits of the EMR, broad departmental membership representation, a practicing physician chair, clear responsibilities and accountabilities and empowerment by top leadership.

The second component focuses on getting end users proficient in the EMR quickly so they can perform the tasks critical to their job.  We develop task specific on-line simulators for each job role.  These are available 24/7 and course completion is documented.  The process takes less time than traditional training and produces much higher proficiency in the EMR. Physicians in particular are appreciative of the rapid and pertinent learning experience and not having to spend hours away from their patient care activities in less effective classroom training.   

The third component emphasizes the importance of metrics.  We measure user knowledge and confidence to ensure long-lasting proficiency.  The clinical and financial outcomes are also critical in tracking the value of adoption.  These metrics guide the organization as they optimize use of the EMR.

Sustaining adoption is often one of the biggest challenges of an EMR implementation.  The fourth component of the model addresses the importance of this effort.  We designed an innovative solution, an online community, which meets the user’s needs.  It provides easy access to information about updates, changes to workflows, education for new users, all task-based simulators and all reference documents and course material.

CMIO Magazine:  How have your solutions made a difference in patient experience?    

Dr. Woodside:  We make an impact on the patient experience by making a difference in the end user experience.  Through effective end-user training and our methodology to ensure adoption, the physicians and their support team use the EMR comfortably and with confidence.  Patients sense this competence which increases their satisfaction and retention within a practice.

CMIO Magazine: When IT costs come under the microscope, how can technology, including that provided by The Breakaway Group, prove that it’s paying its way?

Dr. Woodside: It is only through full adoption of an EMR that the anticipated clinical and financial outcomes will be attained.  Our method sharply focuses on the sustainment of adoption.  We provide a subscription service rather than the more typical time and materials service that ordinarily ends with a go-live event.  Clients may opt to pay for initial professional services followed by a 3-4 year subscription or pay for all services on a subscription basis.

CMIO Magazine: Any closing remarks?

Dr. Woodside: Implementation of EMRs is an event and perhaps the first event toward physician adoption, but it doesn’t end there.  Organizations need to look at their performance metrics to identify any regression in adoption.  There must be focus and commitment from leadership to pursue adoption as an on-going process.