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Who are the key stakeholders in this project? How can they be engaged?

When evaluating who holds a stake in the project's success, cast a wide net. Even peripheral parties to the project can play an integral role in its success. For example, if you do not take patients into account because they do not interact with the EHR interface, the project could be jeopardized. If a patient is uncomfortable with a computer in the exam room, his or her anxieties may turn the doctor against using the system.

Different groups among the staff have various needs and requirements, and all need to be taken into account. Consider the ways in which physicians, nurses, medical assistants, other allied health staff, clerical staff, and IT staff will be affected by the project. The project team needs to reach out to all of them while taking into account the particular circumstances of each.

In addition to staff, numerous other stakeholder groups should be included in your planning. Support from administration can be crucial in the early stages of a project. As noted above, the patient's perspective also needs to be considered.

Finally, health care organizations can play a large role in their surrounding community, especially in smaller and rural settings. Patients should also be engaged in the health IT project to address their concerns and to gain their support. Consider the following questions:

• What effect will your health IT project have on the provision care in various settings (e.g., outpatient, inpatient, home care) in your community?
• What effect will health IT have on potential patients?

By actively engaging these stakeholder groups and encouraging their support of the project, barriers can be lowered and possible resistance preempted.

Identify all stakeholder groups and work to understand how the project will affect them. The basic steps that should be followed to get buy-in are: 1) involvement of users as early as possible, preferably as part of the initial requirements phase, 2) participation of stakeholders and users at vendor demos and site visits, 3) developing a comprehensive training plan and 4) ensuring that users and stakeholders are kept informed of the project implementation. Good communication is the single most important factor. Even when the project encounters significant challenges, candor will win you more stakeholder goodwill than secrecy.

Resources:

• Determine Interest Among Your Colleagues and Staff - AAFP
• Guide for Engaging Clinicians - eHealth Initiative (PDF - 54KB)
• What are EHRs? a resource for patients - NYC Dept of Health (PDF - 164KB)
• Analysis of barriers to EHR adoption - DOQ-IT (PDF - 250KB)