Change Is a Double-Edged Sword
I have spent the last week or so thinking about change and its impact on our day to day existence. Call it a slow week in the Health IT world, but in fact this is a remarkably relevant topic for all of us. Google is buying Motorola Mobility, LDOs are buying SDOs, and international financial turmoil has recently created a roller coaster for everyone except those who have parked their retirement under a mattress. Lately one of the few constants appears to be the sweltering summer heat and humidity many of us are experiencing, but of course this to will change.
Like most people, I have experienced change throughout my life. Sometimes the change was brought on by forces outside my control. Moving to many different cities as a child and living through a couple of corporate acquisitions as an adult are perhaps the best examples. At other times the change was of my own volition. I practiced nephrology in three different states and ultimately chose to pursue a business degree and leave the practice of nephrology. In each case I had the privilege of making the decision (after the appropriate consultations with my other boss).
Regardless of whether the change was of my choosing or one created by circumstances beyond my control, in each instance there was a bit of pain involved. An analogy related to this occurred to me recently. Near the end of 15 years of practicing nephrology, there were days when I felt like I was playing right field. The day consisted of routine fly balls which I tracked down with ease. Every once in a while I had to make a challenging play, sometimes I did and other times I did not. When I made the decision to move full time into the physician executive world, I definitely moved into the infield (not sure if I am a shortstop or a first baseman, but the balls are certainly hit sharper these days).
This past week I had the opportunity to meet with a group of nephrologists from across the country. They were in the midst of an acquisition and I recalled my own experience in their shoes. Part of what they face is the anxiety of uncertainty. Part of it is the dread of leaving the comfort of the familiarity of their current circumstances. In my experience setting clear and achievable expectations along with providing open and transparent communication to all involved are some of the most important factors in mitigating the painful part of the double edged sword.
I think “change management ” is an overused phrase, but it is important to give this process more than just lip service. We attempt to do this in our company today. Replacing a paper based medical record with an electronic health record is one of the most painful changes a nephrologist and his or her practice will go through over the next few years. It is remarkably important to set the right expectations and to communicate clearly. Even when this is executed to perfection implementing and EHR is still an uncomfortable process.
The other edge of the change sword is the one that we face following the transition period. I am more comfortable in my role outside the practice of nephrology than I was three years ago (although I am certainly not back in right field). Similarly, once our customers move beyond the pain of implementation, they too reach a new comfort zone. Dr Shey’s post last week provides a glimpse of the other edge of the sword. In fact, while some of our customers may someday elect to move to a different EHR, very few who have crossed the threshold will ever go back to a paper based record.
The other edge of the pain sword could be described as growth. Those of you with children have seen this up close as your kids learn to walk, ride a bike, interact socially with their peers and, eventually, move out of your home to establish one of their own. Pain is present to some degree with each of these changes but the result is typically worth the price of admission.
By no means do I intend to trivialize something as important as the growth of a child, but if you find yourself pulling your hair out in the midst of an EHR implementation (or perhaps you are in the middle of an acquisition), take a breath, remember the expectations that got you here and communicate, communicate, communicate. This will not take the pain away, but it will soften the blow of the tough side of the sword.