Change management

Change management refers to a systematic approach to adapting to, controlling and effecting change within an organization. In the context of HIT system implementation, Change Management takes into account the engineering and physical process management aspects of installing the new system, as well as the “people” aspects of redesigning organizational and individual work-flow and workers' roles within the new system.

Changing clinical practice to adhere to evolving clinical guidelines, healthcare policy and quality improvement advances is essential to improving patient outcomes. Automated reminders, electronically prescribed medications, medication interaction alerts, and clinical decision support provide an opportunity to improve patient care utilizing technological advances.

Change management is not limited to technological interventions, however, but also accounts for technological interaction with clinicians. Thus, a complete approach to change management must include effective understanding of behavior change theory in order maximize change efficacy.2

Paper

In a paper by Barry P. Chaiken entitled “Strategies for Success: Clinical HIT Implementation,” it is noted that some organizations start their implementation based on the “current state” of their facility, while others are beginning to look at the desired “future state” they are hoping to achieve, and using Change Management principles to move from their current work-flows to the new system. The following “Implementation Strategies for Success” were identified:

Develop an organization-specific clinical HIT implementation model; Identify potential implementation problems with a mock go-live; Treat physicians and nurses equally; Prepare for unique demands that complex clinical systems place on IT staff; [Recognize that i]nvariably it takes more time for users to learn and effectively use clinical systems than users of less complex systems; Forge a strong partnership with the vendor; Practice patience to achieve a successful implementation; Budgeting a minimum of 4 to 5 months to plan a deployment is both prudent and necessary; Let users play with the system; Align IT department goals with overall project goals.³

Applying principles of Change Management to the HIT implementation process can significantly improve the probability of implementation success in an organization.

References

1. [Implementation of Effective Change Management for Successful Integration of Health Information Technology (HIT) Systems in Hospitals. Pattarin Mekanontchai. 2009. University Of Oregon. http://aim.uoregon.edu/research/ebriefings/eb-mekanontchai.php full text at: http://aim.uoregon.edu/research/pdfs/2009-mekanontchai.pdf]
2. [Formula for Successful HIT Change Management. Scott R. Coplan. January 16, 2009. HIT Project Management. http://www.hitprojectmanagement.com/2009/01/formula_for_successful_hit_cha.html]
3. [Strategies for Success: Clinical HIT Implementation. Barry P. Chaiken, MD, FHIMSS. July/August 2008. Patient Safety & Quality Healthcare. http://www.psqh.com/julaug08/hit.html]

Submitted by Tim Gray