The Clinician’s Guide to Surviving Disruption

How Allegheny Health Network's physician-turned-IT leader Robert White mentors clinicians and helps them embrace their evolving roles

Physicians need a lot of technology—and Robert White knows that very well. After all, he was a physician himself for twenty years before making the switch to IT. Although the chief medical information officer at Allegheny Health Network understands which technologies to implement, he says these technologies are only as effective as their user. “It’s not so much about the technology; it’s how we get the clinicians and our colleagues to use it,” White says. For this, he looks to his experience as a mentor.

White developed his educational approach when he was a clinician teaching medical students, where he saw firsthand how people learn differently. Today, he incorporates multiple methods of instruction to account for different learning styles. The key, according to White, is to recognize how people are actually learning to make sure you’ve connected with them.

To connect, White says he makes teaching fun. One of his favorite mentoring experiences came when he was teaching at the University of Illinois, near where he grew up. One day, White went on rounds with the students and found that each one had White’s high school freshman yearbook photo taped over their own badge picture. “Those are the kind of things that happen when you relate to your students, and they recognize that you like to have fun with life,” he says. “That was their
opportunity to do kind of a payback.”

White takes the same approach to teaching his colleagues at Allegheny Health Network. But clinicians can be reluctant to adopt new technology. “Like it or not, physicians were thrust into the world of technology,” he says. Not only are the tools different, but the system is different as well.

“In the old days, we got enabled by all sorts of people: the unit clerk, the secretaries, or the nurses on the units,” White says. Now, physicians accomplish the same work using a different process. “Part of the teaching is to recognize how disruptive certain technologies might be to clinicians or their staff,” he says. “If you don’t understand the status quo, you can’t change the mentality of how to do the work.”

“It’s not so much about the technology; it’s how we get the clinicians and our colleagues to use it.”

As a clinician advocate, White identifies pain points and finds solutions, and then he introduces the new technologies in a way that makes them accessible and easy to use. “You’re talking about impacting their life and how they do their work,” he says. “If you don’t involve them in the work—in the change that you’re inflicting upon them—then you’ve done yourself an injustice.” After introducing a new technology, White establishes
doctor-to-doctor communication to show how the tool can benefit clinicians. He says it’s all about trying to make doctors efficient and proficient by incorporating technology into what they do every day.

One technology White is improving that has a huge impact on day-to-day operations is the records exchange system, both within the Epic information system that Allegheny Health Network uses and with other health systems. In Pennsylvania, the rules around exchanging records are fairly stringent. Since White joined Allegheny Health Network in May 2016, his department has collaborated with legal and compliance to determine the best ways to actively obtain patients’ consent to exchange records.

Along with saving clinicians time, improving the records exchange system improves patient care. “Having rapid access to information helps clinicians make better, faster, more knowledgeable decisions,” White says. Test and diagnosis information helps doctors to determine a differential diagnosis and reduces duplicate testing.

Technology does have its challenges, though. When information wasn’t a button click away, physicians had to know the patient “backward, forward, upside down, and inside out,” according to White. Now, physicians have to remember to look at the patient rather than the screen. If you’re a physician making rounds in a hospital ward, you walk into a room, you bring a computer with you, and you’re talking from the computer, White says. “In my day, if I didn’t have that stuff memorized and if I wasn’t able to articulate what was going on and what was really happening with the patient, I might as well have packed up my white coat and gone somewhere else,” he says.

This is a difficult issue to address from within the technology, according to White, but he says that patient satisfaction is an effective measure. “Sometimes physicians are getting a little bit of a rude awakening to the fact that they’re not paying enough attention to the patients,” he says. Although patients recognize that computers are a factor of contemporary healthcare, White says that how medical teams handle the technology during the course of care is what matters.

Just as clinicians must listen to their patients, White listens to clinicians to determine if his approach is working. Specifically, he listens for silence. “When you don’t have upset doctors and people complaining about a problem and it’s sort of the eerie quiet day after day,” he says, “you realize you’ve done a good job.”