One important component in breaking down the silo is through co-location i.e. facilitating collaboration through the seating/room layout and physical arrangement in which these healthcare workers work together on a day to day basis. Similar to the concept of relationship based healthcare, it is also important to build the trust and camaraderie amongst team mates for them to work seamlessly and effectively.
We are also in the midst of a common EHR implementation for 3 hospitals, a couple of specialist clinics and 10 primary care centers. It is indeed a big challenge given the long standing and different practices and workflows in the various institutions/settings. However, it also presents us a chance to do standardisation. While it is a painful and difficult process which requires alot of negotiation and persuasion, there are times when decisions and stand just have to be made. The selection of project sponsors is crucial and it helps to have clinician leaders because for whatever decisions especially hard decisions they make, they would be impacted and could lead by example to do the right thing.
I think it is important to establish common ground and also to put ourselves in each of the stakeholders’ shoes to see how we can create a win-win situation. That will then help us in formulating the value proposition. Ultimately, it has to make sense to the stakeholders for them to embrace it. Also, if we are not able to get all stakeholders on board all at once, it is important to build a critical mass to eventually succeed in getting the rest on board.