Achieving Clinician Buy-in to Technology

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Achieving Buy-in

Getting the right technology in the hands of the wrong clinicians can spell death for a technology and the vendor or IS department backing it. For example, many cardiologists don't need or want automatic ECG reading machines. Nor do they necessarily want electronic stethoscopes.

At this point, it's important to note that the term "clinician" has been used as a generic term for physician or other healthcare workers. However, it turns out that clinicians are a highly heterogeneous group. Abdominal surgeons and psychologists have very little in common with each other, in terms of their daily work routines, need for information, and time pressure. Furthermore, each will adapt to a technology -- a PDA or EMR, for example -- in different always. In addition, within each specialty, there are technology adoption patterns that become apparent as a function of individual differences.

In appreciating these groups of clinicians, the Berkowitz System of categorizing clinicians is an appropriate classification system. The system, developed by Dr. Lyle L. Berkowitz, is based on 4 types of clinician users, as listed in Table 1 .

Recognizing the 4 types of clinicians in a hospital or clinic can go a long way in insuring successful clinical system implementation, for example. The all-too-common practice of recruiting Technophile Clinicians as contacts and group representatives is a setup for failure. They often have unreasonable expectations, may voice personal concerns and desires that don't have a direct relationship to the clinical needs of the majority of clinicians, and, in general, they can become a resource sink.

Similarly, investing energy into Resistant Clinicians is often a waste of resources, at least initially. This group of clinicians, which tends to be older and either can't or don't want to modify their practice patters to accommodate new technologies, will eventually move to a technology, but in their own time. In the interim, they may rely on nursing staff, residents, and even medical students to actually interface with the technology. It's best to invest initially in Consistent and Variable Clinicians, because they will provide the best clinically relevant feedback. Both groups may require training, which they're generally open to accepting. Resistant or Technophile Clinicians, in contrast, don't want or need training, respectively.

Cite this: Achieving Clinician Buy-in to Technology - Medscape - Dec 27, 2002.

Table 1. The Berkowitz Classification System
Category	Characteristics
Type I: Resistant Clinicians	Technophobe clinicians who will not directly use a technology.
Type II: Variable Clinicians	Clinicians who will only use a new technology in a specific situation, such as using a computer to perform a MEDLINE search.
Type III: Consistent Clinicians	Clinicians who will use a technology, such as a computer system, if it provides some reasonable benefit to their practice.
Type IV: Technophile Clinicians	Clinicians who embrace a technology for its own sake, rather than its clinical relevance.

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