Jones recruited the most enthusiastic users to help in the selectionand implementation of the CPOE system. As the new part-time medicaldirector of information services, Weigle also tried to involve theusers that were the most dubious about the project. Among theunconvinced was Weigle's boss, Dr. Thomas B. Rice, director of thepediatric intensive care unit. "I was skeptical of how the technologycould help me as an end user," says Rice, who has worked at thehospital for 27 years. According to Rice, the flexibility of the ITteam in responding to his and other doctors' concerns was critical."Mike's biggest strength is that he's open," Rice says. "But the keyhas been having [Weigle] involved; he understands the physician end ofit."

Once the interdisciplinaryteam decided to invest US$6 million in the installation of the CPOEsystem from Eclipsys, the next hurdle was training. For the busiestusers, this can be the point of pain. You may have sold them on thebenefits and given them all the right functionality, but if they don'thave time to learn how to use it, all is lost. So Jones decided to cuttraining time. "We limited it to one hour and just trained them in thebasics," says Jones. He also ended up training the most gung horesidents separately from the attending physicians, who were not asmotivated to learn. "We had tried training the old guard and the newguard together in the first training session. The attendings werecomplaining and asking how is this going to work, while it was goingtoo slowly for the residents," Jones explains. "One approach did notfit all."

He supplemented the hour-long intro to CPOE with ongoing support fromusers more familiar with the system. "Doctors learn according to 'seeone, do one, teach one.' You watch someone do an appendectomy, you doone, and then you teach someone else to do it," Holmes explains. "Youhave to ditch the manuals and the long classroom sessions."

Following the launch--half of the physicians were brought on board inJune 2001 and the other half in September 2001--Jones provided 24/7user support the first two weeks after each rollout. Theimplementation has included a great deal of follow-up work. "Someonein IT makes the rounds once a week to all areas of the hospital tolisten to and document complaints," he says.

Adoption rate is now nearly 100 percent, accor-ding to Jones, althougha certain number of surgeons tend to rely on residents to do theircomputerised order entry. He has resigned himself to the fact thatsome may never use the system. But the successful introduction of CPOEhas further enhanced the IT department and the CIO's credibility amonghospital users. Jones is considering several upcoming projects,including a new picture archiving communications system, a move toelectronic medical records, updated operating room systems and apharmacy robot. But he understands that each user group can handleonly so much change. "We would get in trouble if we introduced toomuch change at one time," says Jones.