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Technology is an Enabler but Change Management is Foundational

Contributors

Jessica Rose - Program Delivery Leader, Digital & Integrated Solutions, GE Healthcare

Dipal Dave - Program Delivery Leader, Digital & Integrated Solutions, GE Healthcare

Michael Habodasz - Strategic Director, Strategic and Integrated Solutions, GE Healthcare

Tali Brenner – Data Analyst, Enterprise Care Solutions, GE Healthcare

Why do up to 70% of Healthcare projects fail?1

Because we often rely on technology to solve a problem.  Instead, we fail to identify the appropriate business need, we neglect to focus on the change management, and we skip the fundamental planning steps at the foundation of the project.  Moreover, this isn’t a new problem, and the healthcare industry isn’t alone. 

The Tower of Pisa, also known as the Leaning Tower of Pisa, who’s construction began in 1173, is a clear example of this.  The tower’s builders realized it was leaning by the time they got to the 3rd story. The lean was the result of a poor foundation of stones laid on soft ground.  The engineers and architect attempted to course correct by making the next stories taller on the tower’s shorter side. This solution caused the tower to sink even more but failed to solve the problem’s root cause. Until 1990, after attempting to address the foundational issues, the Tower leaned at a 10-degree angle.2

The question is, how do we prevent the tower from leaning before we even begin building?  The answer lies in how we approach projects.  The different approaches between transactional or solution providers makes a significant impact on a project’s outcome.

A transactional provider focuses on the technology.

But, once the project is complete, they leave. They focus on the implementation, but not necessarily on the foundation.  As a result, the implemented technology is stale and lacks user adoption.  Despite excellent building material, without proper foundation, the tower would still lean.  Solution providers see the big picture. They work with customers to establish an appropriate foundation. They see the go-live, not as the end, but rather a milestone of the overarching goal or program. Their approach relies on feedback from the customer for improvement.

A solution provider is someone who:
  • Seeks to understand the problem and its root causes
  • Identifies the appropriate solution
  • Establishes and sustains governance support
  • Focuses on both people change management and technology with the same rigor
  • Assesses technologies’ relevance and effectiveness
  • Processes on a regular basis to create improvements and changes

As an example, Digital Centralized Monitoring Units (DCMU) can yield many benefits to hospitals, end users, clinicians, and patients. One potential benefit is a reduction in alarms. A hospital may not realize these benefits working with a transactional provider focused on technology alone. Successful implementations require in-depth understanding of customer needs, current practices, and implementation requirements. Moreover, an in-depth customer needs assessment should shape how customers measure success. In turn, collaboration among stakeholders and user adoption is low.

The chart below represents a hospital on the West Coast which monitors 255 licensed telemetry beds using this GE digital monitoring solution, where the GE Healthcare Outcomes team engaged a customer to implement a DCMU. The Outcomes team employed a solutions approach to address the hospital’s clinical leadership. Starting with the foundations, the team approached all levels of stakeholders for feedback.  The feedback led to user interface adjustments, improved engagement, and increased end-user utilization.  By leveraging a solution approach, the customer decreased monthly alarms from ~9200 per month to ~3007 per month: a 67% decrease in alarms, shown in the graph below taken from the customer’s GE reporting module associated with this solution. 

Chart showing difference between solution vs transactional providers

Solution providers must seek to understand the problems. Then they must provide appropriate solutions that address the problem’s foundation. For an effective outcome, solution providers must collaborate with customers to establish new processes and foster change management. As a result, both customer and provider will see the technologies’ benefits in users.

It is important to remember even for the best technology, a transactional approach cannot deliver user adoption.  A comprehensive solution approach requires:
1) evaluation of current state processes
2) careful communication and collaboration
3) effective training
4) go-live support
5) Post-implementation assessment

The solution provider implements with the customer, instead of for the customer.

Much like a building that starts with a strong foundation and then undergoes regular maintenance, a solution provider approach continues to monitor technology and processes for relevance and effectiveness. 


References

1. https://www.ehrinpractice.com/ehr-failure-statistics.html#:~:text=Research%20published%20in%20the%20journal,meet%20an%20intended%20goal%2C%20or

2. http://www.towerofpisa.org/