You might have people who accept the evolutionary change and stay, people who don’t and leave, or people who can’t and are eventually eliminated by some organizational variant of natural selection.
In moving from a paper-based to electronic medical records system, change may appear in either form in an organization. It may come in as a revolution and up-end the status quo, sweeping away the old way of business and bringing with it all new systems and processes. For most organizations, federal mandates are the change agent. Do it or don’t get paid (eventually).
Without government mandates, without a doubt, electronic medical records would eventually be integrated into the healthcare environment through a more gentle, evolutionary process. Simply, medical schools are graduating tech-savvy providers who are used to doing everything online. The nurses, doctors, pharmacists, staff and executives in healthcare organizations do everything better, faster and smarter with technology in other areas of their lives. Over time, healthcare providers will expect to take those technological advantages to work with them.
Because the change is being pushed from the top down, rather than being sought from the bottom up, it takes a little more organized effort from the training and human resources staff to pull through the technology. In a revolutionary change model, you’ve gotta prepare people for change and the new technology you are requiring; in the evolutionary change model, you just have to manage the naturally occurring change and supply the technology for people who are seeking it.
Most healthcare organizations are in a revolutionary, top-down mode for managing the change in their environments. Some organizations are in the evolutionary, bottom-up mode, but they are still fewer and farther between. [HIMSS EMR Adoption Model]
In another generation, the full integration of IT into the healthcare environment would be a natural and evolutionary process. And that might seem like a kinder, gentler approach. But you have to start somewhere, sometime, setting standards and goals, and putting the network in place to handle the integration. That calls for a revolution of sorts – change here, change now, and change according to a master plan. That’s where we are today.
By requiring providers to integrate health information technology into their work environments now, the federal government is pushing the revolution from the top down. What that means in terms of organizational development is that the change will require some hands-on management from the people responsible for pulling it off on the ground.
Evolution is nice, things change according to the natural flow of events within the context of their times. Revolution sometimes is necessary to move things firmly forward toward a defined vision in an organized way.
Welcome to the revolution.