Resistance to change
, declining productivity, and an exodus of employees are just a few of a change manager’s worst nightmares. When it comes to digital transformation, they can easily become reality. The healthcare industry is an excellent example of the obstacles organizations face when going digital. Digital transformation in healthcare — namely the transition from paper medical records to digital systems — began after providers and government leaders recognized the need to better collect, coordinate, and use patient data. Digitizing medical records was supposed to improve care for patients and productivity and efficiency for clinicians. Yet, several years after the switch, healthcare professionals are still challenged to work with electronic health records (EHRs).
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The disruption clinicians experienced throughout digital transformation in healthcare exemplifies some of the primary challenges organizations should anticipate when undergoing similar changes.
Digital Transformation Leads to Industry-Wide Frustration
The U.S. government established an EHR certification program called Meaningful Use under the Health Information Technology for Economic and Clinical Health Act of 2009. The Act sought to “promote the adoption and meaningful use of health information technology” in healthcare settings, according to HHS
. As part of the program, the Centers for Medicare & Medicaid Services (CMS) provides incentive payments to eligible hospitals and physician practices that implemented EHRs. In exchange for the payments, providers must demonstrate that they are using digital medical records to improve the quality and coordination of care. Healthcare providers that fail to attest to certain standards are subject to penalties.
Clinicians and healthcare leaders hoped digitizing medical records would improve the quality, safety, and efficiency of healthcare services. But many clinicians consider EHR systems a disruptive force in the practice of medicine.
What went wrong?
Physicians and nurses lament poor system usability, lost productivity and workflow interruptions due to EHR requirements. They say EHR platforms are time-consuming and not intuitive, and the constant need to enter in data diminishes the quality of interactions with patients. For example, a 2016 study
published in the Annals of Internal Medicine
found ambulatory physicians reported spending 50% of their work day entering data into EHRs.
In comparison, they reported spending 27% of their time interacting with patients.
And during patient appointments, physicians said they spend 37% of their time on EHR and other desk work. Researchers have also identified the clerical burden associated with EHRs as a major contributor to physician burnout, according to a study published in Mayo Clinic Proceedings
. Burnout threatens patient care quality and access, in addition to physicians’ mental health. “Burnout has been shown to erode quality of care, increase risk of medical errors, and lead physicians to reduce clinical work hours, suggesting that the net effect of these electronic tools on quality of care for the U.S. healthcare system is less clear
,” Tait Shanafelt, MD, a physician at Rochester, Minn.-based Mayo Clinic and lead author of the study, said in a statement
. The digital transformation in healthcare upended the way physicians work. Moreover, EHRs can provoke enough mental fatigue and stress to drive some of clinicians out of the field altogether. A survey
from locumstory.com found 55% of physicians have considered quitting medicine, with 68% citing time spent entering data into EHRs as a primary reason.
5 Lessons From the Digital Transformation in Healthcare
The threat of poorly executed digital transformation is distilled in the healthcare example because so much is at stake for both providers and patients. Change leaders
in any industry can learn from the healthcare sector to boost their own digital transformation efforts. Here are 5 lessons on digital transformation from healthcare.
1. Focus on Training Prior to Implementation
The introduction of EHRs spurred resistance among clinicians because it disrupted their workflows, and the benefits of the technology were not clear to the users. Although hospitals and physician practices worked long and hard with EHR vendors on implementation and training, gaps remained. Before implementing a new technology, leaders should allow those who will be using the tool to become accustomed to using it. In addition to providing hands-on training
, clarify the purpose the technology will serve, and highlight the benefits it will yield.
You can preempt resistance by anticipating issues and addressing them before they occur. Employees are inherently wary of change because change means uncertainty. But if they gain a clear picture of how their roles and daily workflow will be different, they will be more receptive to learning how to use new technology. Employees will also be less resistant when less effort is required of them. Solutions that enable users with low tech aptitude to complete tasks easily are a sure way to mitigate resistance, while improving productivity.
2. Promote Buy-In by Identifying Champions
Champions are integral to digital transformation efforts. Champions are individuals who serve as credible influencers among their peers. They don’t need to hold a formal leadership appointment, but they must be trusted, respected, and able to rally support for change. During a digital transformation, champions are tasked with promoting buy-in among staff by demonstrating enthusiasm about the new tools. They also establish clear lines of communication between staff and the C-suite. Champions help garner trust across the organization, which is essential for successful change. Physician champions are critical to change management in the practice of medicine because they understand their peers’ workflow and share the same goals and concerns. Other physicians trust them to relay their feedback to the leadership, and to advocate on their behalf. However, during EHR implementations amid digital transformation in healthcare, critics’ voices were much louder than supporters’.
3. Embed the New Technology into the Organization’s Culture
The oft-repeated adage “culture eats strategy for breakfast” gets repeated because it’s true. Change managers and IT leaders can design a digital transformation effort to the tee, but if the organization doesn’t possess a culture of innovation, the effort will fall flat. The healthcare industry as a whole is relatively resistant to change because clinicians tend to subscribe to evidence-based reasoning. If they cannot see exactly how a new tool or process will help them take better care of patients, they might not believe it’s worth implementing. This mindset was a fundamental obstacle during the digital transformation in healthcare.
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While acknowledging that change might be difficult or feel personal to employees, leaders must promote a culture that values constant improvement and innovation. In healthcare, that means always being prepared to provide a case for change. Just as medicine continually seeks to advance, people within an organization should embrace tools that enable them to work better.
4. Ensure the Technology Fulfills its Promise
We would be remiss not to mention the glaring fact the many EHR systems are difficult to use, plain and simple. No matter how comprehensive training is, employees will likely resist new technology if it’s too complex. Clinicians often complain EHRs are not intuitive by design, they lead to click fatigue, and they are time-consuming and distracting. Overall, there is much room for improvement.
When embarking on a digital transformation, make sure the new technology fulfills its full potential. If not, consider supplementing the technology with a tool to help users navigate it more effectively. For physicians, this is the critical difference that ensures technology will never be an obstacle to quality care.
5. Make Support Continually Available
A digital initiative may have a specific start date, but the end date is not as clear. It takes time for users to acclimate to a new technology system. Therefore, learning should extend beyond the implementation period. Employee resistance often comes from the frustration of not knowing how to do something, especially when time is limited. In healthcare, clinicians who struggle to use an EHR not only feel overwhelmed and stressed, but they can also contribute to coding and billing errors, resulting in lower revenue and a worse patient experience. By offering continual support, you can quell resistance among users and empower employees to perform at an optimal level. Set your employees up for success during a digital transformation by providing them with tools to make this possible.