IT Consulting from the Trenches

ABOUT A DOCTOR’S PRIDE & RIDING A HORSE

I commented on an online BusinessWeek article entitled “Doctors’ Pride: A Hurdle to Digital Medicine.”

The article’s point was that healthcare organizations should not ignore emotions, specifically the professional pride of a key stakeholder, the physician, in its computerization drive.

The change from paper- and film-based records to digital-based ones is wrenching for most parties involved—the healthcare organization, the physicians and other caregivers, the financial intermediaries (insurance companies), and the government. The best seat in the house probably belongs to the patient who, for the most part, just needs to cooperate and be patient.

The change, in short, is revolutionary. A sea-change like this requires the change managers to factor in the emotional reactions of all stakeholders.

The article recounts the learning experience of one of America’s largest hospital networks. The network, a healthcare organization, forced 4,500 doctors who do business with its hospitals to install—at the doctor’s expense—a specific IT system in their respective offices. This would enable every doctor to communicate with the hospital network and, through the network, with other caregivers. There are several good reasons for this. To name just one, it would improve the coordination between physicians especially between physicians of different specialties.

Technology has sped up the pace of life. Technology brings about change—change in workflows and processes—and, as noted in one of my blog entries (click here), persuading people to change their habits is not an easy task. Even rational reasons will fail. Note how difficult it is for people who live an unhealthy lifestyle to change. Sedentary people typically find it difficult to make working out at the gym a habit. Overweight people typically find it difficult to control their eating.

A Doctor’s Pride

At any rate, the article’s subtitle says it all. “A forerunner in New England found that some physicians would sooner cut ties than see their elite status threatened.” The first comment to this article was written by a doctor.

dan1138
Apr 24, 2009 8:37 PM GMT

As a doctor I find this to be a truly ignorant article. We work in teams all of the time. If doctors are reluctant to give up final authority, it’s because we have ultimate responsibility as well- spelled LAWSUIT. In the case cited, how would like to have a $25,000 system shoved down your throat, even if it negates all the work you’ve done with another system or forces you to change your- day-to-day practice ? I’d tell ’em to get lost, too.

I submitted the following comment in response.

Alex Pronove
Apr 25, 2009 11:18 PM GMT

It appears that the second comment, made by dan1138, justifies the title of this article. The dismissive tone suggests that he wrote it with emotions rather than cognitive reasoning in his mind. A major point of the article is teamwork, as in the example of a diabetic in the penultimate paragraph. Teamwork should improve the outcome and, consequently, reduce the likelihood or severity of dan1138’s concern (spelled LAWSUIT). His attitude seems to reflect hurt pride indeed.

ITIL

ITIL stands for the Information Technology Infrastructure Library. ITIL is a compilation of what businesses call “best practices.” I reviewed ITIL in another blog entry (click here). In it, I remarked at how it pleasantly surprised me. One surprise: don’t be misled by its roots in Information Technology. ITIL’s best practices are applicable to many situations in different fields.

Change Management

One vital piece of ITIL’s framework is change management. That’s correct—change management. Today, change—whether it’s in our work or personal space—comes so frequently and, sometimes, so strongly that a discipline emerged simply to understand and manage it. Change management is the field focused on controlling the risk and minimizing the adverse impact of change. The goal of change management is to facilitate the target’s adoption of the change. Adopt and adapt, you might say.

This is an appropriate definition of change management:

Change management is a systematic approach to dealing with change, both from the perspective of an organization and on the individual level. Change management has at least three different aspects: adapting to change, controlling change, and effecting change. A proactive approach to dealing with change is at the core of all three aspects. For an organization, change management means defining and implementing procedures and/or technologies to deal with changes in the business environment and to profit from changing opportunities.

Successful adaptation to change is as crucial within an organization as it is in the natural world. Just like plants and animals, organizations and the individuals in them inevitably encounter changing conditions that they are powerless to control. The more effectively you deal with change, the more likely you are to thrive. Adaptation might involve establishing a structured methodology for responding to changes in the business environment (such as a fluctuation in the economy, or a threat from a competitor) or establishing coping mechanisms for responding to changes in the workplace (such as new policies, or technologies).

Terry Paulson, the author of Paulson on Change, quotes an uncle’s advice: “It’s easiest to ride a horse in the direction it is going.” In other words, don’t struggle against change; learn to use it to your advantage.

Ride that Horse!

If the healthcare sector is a horse, then the American Recovery and Reinvestment Act of 2009 (Recovery Act) that was signed into law by President Obama two months ago gave it a big kick. According to the Department of Education:

“The act is an unprecedented effort to jumpstart our economy, create or save millions of jobs, and put a down payment on addressing long-neglected challenges so our country can thrive in the 21st century. The act is an extraordinary response to a crisis unlike any since the Great Depression, and includes measures to modernize our nation’s infrastructure, enhance energy independence, expand educational opportunities, preserve and improve affordable health care, provide tax relief, and protect those in greatest need.”

Returning to the original article, “Doctors’ Pride: A Hurdle to Digital Medicine,” I appreciated it more for reporting on the lesson that was learned from the change experience than anything else. As the author’s concluding paragraph notes:

No studies have yet been published to determine whether Partners (the hospital network) has saved any money since going digital. Nor has the network determined whether care has improved. But it now has the data to carry out those studies, and it plans to do so soon.

Now I call that horse riding—in the right direction!