Hello, You are absolutely right! Engaging employees, effective communication, and collaboration will create any modification effort additional productive.

is the health care electronic database and electronic health records are the same?

This is a fantastic perspective on the hidden resistance associated with practice implementation. I am interested in receiving more information.

Ten years into an EHR (early adopter, highly motivated, engineering background) all I've learned for sure is that EHR's (I've used Meditec, Sage-Intergy, Allscripts, EPIC, Cerner, and McKesson products) cost money (to install and maintain), take time (far more than non EHR methods in use for years prior to EHRs), and do not improve errors - just changes them. By and large, EHRs change the patient encounter, frequently for the worse, and the heath care delivery event shifts from being patient centered to EHR centered. As an tracking or measurement tool, it has some application, but even this is subject to error (garbage in, garbage out). No amount of engagement, communication, or effort can change the fact that EHR's are frequently overly complex, force choices that are not nuanced, and add unnecessary information density which can obscure pertinent facts. In the old days I could produce a one paragraph typed note which conveyed all that was necessary. A similar EHR encounter now generates 3-4 pages of documentation which only a sadist or malpractice lawyer will read, and likely not easily comprehend what actually happened. I have practiced medicine for 25 years and I am glad I only have a few more years to go. My biggest fear is that I will eventually become the patient, and have doctors, nurses, and staff members focused on a computer screen and not me.

You are absolutely right! Engaging staff, effective communication, and collaboration can make any change effort more successful. Too often they are imposed on staff who have been ignored or dismissed and/or toxic cultures. Resistance becomes a perverse sense of having power in processes in addition to having limited time. I'll eventually blog about this very succinct and helpful youtube at "Confident Voices in Healthcare Blog and email you for current research.

Thanks for the information.