We are Physician Builders (ukulele EHR parody)

Here we are at #ugm2018 Epic’s annual User Group Meeting. We’re at our first Directors’ Advisory Council session with over 600 attendees, and we discussed our governance approach to Physician Builders and how we overcame internal resistance to the idea that Physicians could do a good job creating new designs, templates, smart tools, and other content (and some actual programming) in the Electronic Health Record (they can!). In fact, our 19 Physicians who are now certified builders have made substantial improvements to our EHR environment on behalf of numerous medical and surgical specialties, as well as our physician users in general.

The point being, that although IT analysts are terrific for creating most of the content of the EHR, having physician builders with deep knowledge of the EHR technology leads to some interesting capabilities:

  1. Physician informaticists, with clinical knowledge, strong communication skills, and now technical know-how, can help other physicians reduce the EHR burden by matching tools to the clinical scenario, and reduce cognitive burden. For example, it is difficult to order the right cardiac arrhythmia monitoring tool (Holter? Event Monitor? Zio? Some other device?). Instead of building what a cardiologist physician was requesting, our physician builder thought about it, and suggested some the creation of a cascading order panel that gently guides the ordering physician to the right order WITHOUT building an exhaustive long checklist with difficult-to-follow paragraphs of instructions. Having a foot in both worlds is beneficial in this case.
  2. It is delicate and important do develop EXCELLENT relationships, CLEAR communication and strong guidelines so that the IT analyst team and the physician builders know what to expect from each other. When done poorly, turf battles erupt: “don’t touch those tools that I built!” But, done well, we become a synergistic team: “wow, thanks for taking on those Express Lanes; we would not have achieved our Honor Roll status (and helped all those urgent care centers) without your help.”

Really proud of our high functioning team.

And to ensure our audience got the point, we sang them our song. Lyrics below, YouTube link above.

We’re Physician Builders (Champions, Queen)

I’m a frustrated doc. Am Em
Passed my builder test
I wanna build
But she says: ‘You jest!’

And bad mistakes. C F
I’ve made a few
I’ve had my share of bad code kicked in my face C G Am
But I’ve come through! D7 G A

We’re physician builders, my friend D F#m Bm G A
And we’ll keep on buildin’ ’til the end D F#m G A
We’re physician builders, we are the builders Em A7 Gm A7
Those are happy users, cause we are the builders D C F G7
Of an Epic world. G7 D

I’ve set up smartlists. Am Em
And CER rules
You sent us Foundation and everything that GOES w it
I love those smart tools.

And maybe with time C F
Create a team goal,
We’ll share build in Text and Hyperspace
And make Honor Roll! C G Am D7 G A

We’re physician builders, my friend. D F#m Bm G A
And we’ll keep on buildin’ ’til the end. D F#m G A
We’re physician builders, we are the builders Em A7 Gm A7
Those are happy users, cause we are the builders
Of an Epic world.  D C Bb G7 D

CMIO’s take? What are YOU doing to ensure that you don’t take yourself too seriously? Are you here at Epic #ugm2018? Let me know!

Author: CT Lin

CMIO, UCHealth (Colorado); Professor, University of Colorado School of Medicine

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