2022 was the year of digitalization in Tatarstan, a small republic in Russia.
As part of this, the digitalization of one of the most important hospitals, the Regional Clinical Hospital (RCH), was pursued under the government’s National Healthcare and Demography projects.
Within ten months of the digital transformation, the hospital met the requirements for the Stage 6 HIMSS Model for adoption of electronic health records (EMRAM), a model that measures the acceptance and maturity of an organization’s use of the EMR.
But in achieving this incredible feat, RCH faced resistance from within.
“Information technologies are often seen as less of a priority by staff, therefore the implementation of the new medical information system and protocols has been met with resistance from some staff who are key stakeholders in this process,” RCH chief marketing officer. Diana Altynbaeva shared in the session: “Digital transformation in 10 months according to EMRAM standards: recipe from one of the phase 6 hospitals.”
To overcome workforce resistance, RCH turned to the HIMSS approach to digitalization.
“Overcoming the resistance of 300 employees was a big challenge for (us),” admitted Altynbaeva, who was tasked with selling the idea of implementing the HIMSS standards and a new medical information system.
“We created a group of commissioners for the implementation of HIMSS standards. Change agents were appointed across all structural divisions; they served as our partners in demonstrating a culture of openness and security based on HIMSS standards.”
Hospital administrators also engaged staff in open dialogue to discuss issues.
“Russian doctors are perfectionists by nature. And if a doctor admits a mistake, it is a huge mental barrier that keeps our medicine conservative,” Altynbaeva claimed. “We have trained our staff that it is important to talk about errors and risks – and we continue to do so.”
Altynbaeva’s team also provided educational courses, short lectures and training to get their staff on board with the new digital system.
A culture of openness
During the process of achieving Stage 6 EMRAM certification, RCH needed to digitize its incident management system. This new system resulted in an increase in incident reports that had never been seen before.
“The preparation for certification and the introduction of HIMSS standards have made it possible to find a clinic management model that meets modern challenges, provides high-tech safety and lays the foundation for a culture of openness,” said Altynbaeva.
“Today, our specialists willingly report incidents they encounter, because they know that this is a tool to (guarantee) the safety of their patients and themselves and their colleagues. We can say that our approach to recording incidents is quite transparent.”
Overall, Altynbaeva attributed the success of their recent Stage 6 EMRAM performance to their effective change management.
“Work with staff was organized according to the best methods to involve them in the stages of implementing changes.”
RCH also could not have done this without the tremendous and timely support from the Government of Tatarstan and the hospital’s stakeholders.
“In the search for optimal approaches in the application of digital solutions and the management of a multidisciplinary clinic, the HIMSS approach was identified as the only standard in the world that combines and evaluates medical business processes, personnel, medical standards and information technologies in a single bundle to ensure patient safety,” Altynbaeva explains.
RCH is now pursuing Stage 7 EMRAM, which if successful would make them second in achieving this validation in Russia, behind the Nikiforov Russian Center of Emergency and Radiation Medicine in St. Petersburg.