My Yoda is a practicing physician and CMIO.  We were reviewing observations from the implementation of his EHR.  His first observation was that only about 20% of the effort/risk/complexity had to do with the EHR technology.  The other 80%–people, process, and things (change management, politics, training, user acceptance).

His mantra… “It’s not just taking the paper and putting it on the screen” and “You *REALLY* need to understand your workflows before you come to bargain workflow changes” and so on…

It’s great to have words, but without believers, the words are foundless.  How did he get believers?  He created the Jedi Council, comprised of Clinical Jedis.  Used with his permission, the following is their ‘job description.’

“Clinical Jedis” :
1. Work clinically at least 50% of the time
2. Are PASSIONATE about understanding the workflows of their little niches.
3. Are devoted to intellectual purity.
4. Are devoted to political purity.
5. Believe in the importance of political negotiation.
6. Each serve a master: Their own clinical specialty.
7. See “Jedi Activities” as something separate than their general clinical work.
8. Embrace technology.
9. Understand the importance of workflow bargaining, and how it impacts the harmony of the universe (hospital) all together.
10. Meet every two weeks, OUTSIDE of the hospital, in an apolitical manner
11. Bring clinical issues to the IT table.
12. Bring IT issues back to their clinical tables.
13. Have a few “weapons” at their disposal, which they should only use when political negotiations have broken down:
a. The “Jedi Mind Trick” – Sales pitch to their clinical/IT colleagues, e.g. “You WILL use this order set”
b. The “Blaster” – Going back to their department directors and saying “We need to exert political muscle to get this change done”
c. The “Lightsaber” – Through me, I have direct relationship with the hospital administration, and if we need the CEO to say “This is how it’s going be”, we can do it like that.
14. Act as a resource for clinical department directors to figure out “How do we do things?”
15. Act as a resource for IT directors to figure out “If we change this, what is it going to do in other departments?”
16. Help hospital administrators understand how their hospital is run.
17. Are well-respected by their clinical peers (So far, each department director LOVES having a “Jedi” protecting their clinical niches… This is the secret key to getting “buy-in” – Directors are MUCH MORE WILLING to change when their own personal Jedi says, “This is how we have to do things”)
18. Own and design their own order sets.
19. Own and design their own workflows.
20. By design, the workgroup has no FORMAL reporting responsibility to any part of the hospital, so that it doesn’t get shot down in formation : “Hey, you do education? Not if I can help it! *I* do education!!”

Are you doing anything like this?