Training and Change Management Maximize Our Investment in Health Information Technology

Peggy Salvatore, MBA

I love a good think tank study. So here we go: a KPMG survey suggests training and change management are bigger barriers than technology implementation in achieving federal health IT standards.

Let’s look at this study in light of two other headlines this morning, February 11, from Healthcare IT News:

“Sebelius: ‘Speed up the rate of change’” and “EHRs top priority for CIOs”

We are partway there, but can we get there faster and work out the bugs?

Sometimes an analogy is helpful, so let’s break down the rapid, billion-dollar deployment of electronic patient records throughout one-sixth of our economy into a simple multi-million dollar story of a small company.

Let’s pretend you own a company, a few hundred employees, and your company is 40 years old. You make the hypothetical widgets, you are the Widget King. You’ve been operating your business – the books, the customers, the vendors, the employees – on a terrific old mainframe that has served you well. It’s not quite as old as Eniac but you are still printing out reports on tractor printers – and it’s getting darn hard to get the paper these days. The times, they are a-changing and so must you.

As your faithful, long-time machinists, bookkeepers, manufacturing assembly workers and shippers are retiring, you are bringing new people into this tightly held, well-run organization that has been your baby since you were in your 20s. Some of these freshly minted MBAs and IT whizzes say you can get a lot more done in a much quicker way with a fresh infusion of cash – say $5 million – in new technology to make your company more competitive and nimble in the new economy. It’s an easy sell. You’ve noticed that the market seems to be getting away from you. The MBAs and IT analysts say you can maximize your impact and increase revenue exponentially by collecting the data you have and analyzing it to segment your market, streamline your processes and create new connections among employees, customers and vendors. You’re sharp, you became successful because you can read the tea leaves.

So you spend the $5 million.

But your staff is still heavily populated by veteran employees. They are not very happy with the way the new technology changes the way they do their jobs. There is resistance to new hardware and software. There is reluctance among your older customers that you are changing some of the ways you invoice and market to them, and some of your long-time vendors just aren’t quite comfortable with the new way of relating to your company. Sure, some of your customers and vendors have been waiting for you to catch up to them, but there remains some resistance internally and externally. Newer might be better, but it’s different.

What’s a sharp CEO like you to do? You’ve spent $5 million, it was money well-spent IF the new technology is used well. If not, you can’t really go back to Son-of-Eniac. So you need to bring your people along with you.

Your MBA recommends bringing in an Organizational Development specialist. The OD person says:

• Sara in bookkeeping is complaining that she doesn’t understand the new screens and fields on her desktop – perhaps some software training for her?
• The shipping department is getting behind because they are spending an inordinate amount of time trying to figure out the new system – perhaps some process modifications
  supported by training shipping department supervisors in the new systems and teaching them how to coach their employees on the new processes
• Water cooler and lunchroom chatter is turning negative because the new system is slowing things down – perhaps some team building
•  And then there is the tension between the old guard and the infusion of new talent and ideas – how about some cross-generational leadership training

The inventor of the widget realized the $5 million in new technology was just the first step; now he needed to invest in the people who will make the $5 million technology work. Soon, the company was humming along again, and moving gracefully into the 21^st Century.

Take the story of the Widget King and extrapolate that a gazillion times over in dollars, complexity, products and people to one-sixth of our economy that is heavily populated by staff that has been used to doing business the old way rubbing up against people heavily invested in doing things a new way.

In health IT, the upfront investment in hardware and software is being made, much of it by our government so this is your tax dollars at work affecting the quality and cost of your healthcare. There is no turning back. So perhaps it behooves us to help this large and complex machine we call our health system move gracefully into the 21^st Century. Let’s throw good money after good and invest in training and change management to reap the benefits of the billions that we’ve spent, to get things running smoothly sooner – all for the better.

Sources:

KPMG Study: KPMG survey suggests training and change management are bigger barriers than technology implementation in achieving federal health IT standards.

Sebelius: 'Speed up the rate of change'. By Mary Mosquera, Senior Editor. 

EHRs top priority for CIOs. By Diana Manos, Senior Editor.

Comments

[Jonena Relth]

Spot on Peggy except it would be wise to bring in Lean experts to take a serious look at your processes - current and future state. They should work alongside the current employees and the OD folks to make sure that while you're "bringing your company up to today's standards", you're making only changes that add value and eliminate waste. Might as well end up with the best, most efficiently run company you can!

[Peggy Salvatore]

Great point, Jo. I'd like to hear more.

[Dallas IT Consulting]

I've been looking for information about investing in Health IT. Good thing I have bumped into your article. Thanks.