A few years into the transition to an electronic health record system, leaders at Holy Family Memorial, in Manitowoc, Wis., could see that it would take more than just handing doctors a laptop to improve communication and coordination among caregivers.

The rural provider has made a concerted effort in recent years to ensure that its doctors are communicating with each other — as well as with patients and nonclinical staff. Those efforts have included everything from chewing over communication styles to doctor-to-doctor messaging, says Stephen Driggers, M.D., chief medical information officer at Holy Family.

"Our society, in general, mistakes information and data for communication," he says. "We think if we simply talk long enough and hard enough, people will understand. Communication is about thinking before engaging and then putting things in both the right language and context for the audience."

Holy Family has implemented electronic health records gradually in recent years, and is now at the point where all charts are paper-free. But around two years ago, it hit a wall, and was having a hard time coordinating care to the desired level. Information was getting lost in the system and doctors were becoming "data-and information-rich and wisdom-poor," Driggers says.

To bust down that wall, hospital leaders rolled out a slew of new communication tools — secure internal emailing between doctors, a workload management program to coordinate care between doctors in patient-centered medical homes, cellphones loaded with other doctors' contact information, and electronic referral templates that can be accessed by everyone along the care path. Apart from the technical side, Holy Family also assessed doctors' communication styles and then organized medical staff retreats to discuss them.

Driggers acknowledges that there was a fair amount of resistance. The level of "absolute panic" was so bad early on that a couple of physicians even retired rather than buy into the changes, says Evelyn Sbar, associate medical director of care coordination and a family practice physician at Holy Family. Driggers points out, though, that some 95 percent of the hospitals' medical staff is employed, so urging them to get on board with the changes was a little easier.

Larry Verlinden, M.D., a family practice physician, had concerns that his eyes would be too focused on a computer screen and not on his patients, but he says the EHR has bolstered communications.

"It has dramatically changed how many of us have practiced medicine — even some of the people who have been here long before. At this point, it would be hard to imagine coordinating all this care without it," Sbar says.