Where to start?

This is a simple yet very interesting question as it begins with many variables that would impact the answer. Where to start depends on your organization structure, organizational complexities, current governance in place, current IT strategy or path and its alignment with meaningful use and most importantly how engaged are the clinicians in the process today....ok...too many variables.... start with a Blocker and Squid assessment.

This simple assessment tool is something that was presented at some conference along the way and I can't even recall who the presenter was or where it was presented. I do think the presenter would be proud that the concept sank in and was applied successfully.

Here it is:
Four quadrants  = Blocker, Squid, Allie, Champion

Definition of each:
Blocker = Someone that is completely against the idea and has the ability to influence other key stakeholders. This person could send your initiative is a tailspin rather quickly.

Squid = Not against and not for the initiative. Floats around the topics and is not overly engaged in the process. A squid could communicate that the initiative is not important but also does this by not saying a negative word. Just the actions alone...just like a squid floating in the ocean.''

Allie = Right there with you. Engaged in the process and the initiative but not necessarily taking a lead role

Champion = The person who would stand shoulder to shoulder with you from the beginning to the end. Will stand in front of the hard decisions that are made during a transition to meaningful use and will help influence all of the Blockers, Squids, and Allies to do more for the good of the organization and the overall goals.

Your job = Plot the key stakeholders into the appropriate category.

What are your results? I am going to assume heavy on the Squids and Allies with a couple of Blockers. Is the only champion you? Is it only you and maybe one other person? If you are heavy on the Squids, you have a problem. If you have a few Blockers, who are they? Are they very influential? If yes, you have a problem.

Your goal is to begin to shift your Blockers and Squids. Fill in the Allie box. Build a few Champions. These key stakeholders are not just key stakeholders but also future users of the systems to be deployed to achieve meaningful use. This shift will take time and make sure you have one thing in your toolbox ready to go.... an open schedule for dinner. It may take a few steak dinners to make the shift happen but at the end, the path to meaningful use is much clearer and to have a few friends on the journey with you makes it much more enjoyable....otherwise you have some back seat drivers.

Good luck starting.