It All Comes Down to Leadership

Today I spoke at the South Carolina Hospital Association’s Executive Leadership Summit in Charleston, SC. The Association put on a great meeting, and it appeared there were about 100 CEOs and COOs in the room. In what must have been a scheduling “challenge,” SCHA managed to get both gubernatorial candidates to show up to speak. Both Nikki Haley (R) and Vincent Sheheen (D) spoke about employment and healthcare issues in the state which, like several others today, faces serious budget issues. Both took several questions from the audience. Earlier in the day I presented a high level overview of the role of technology and the responsibility leaders have in ensuring it’s successful implementation.

Some key points I tried to make:

Successful health reform is “technology dependent”
Pretty much everything found in the healthcare reform bill will require significant amounts of information, managed in new ways, to accomplish new things. The HITECH act requires that information technology be present, as an underlying component of a more modern healthcare system. In the near-term, the move to increasingly paperless clinical processes will have everyone’s attention (at least in the US), because of the associated incentives for success and penalties for non-compliance. But the longer-term outlook shows an increasing reliance on information technology to support the myriad changes coming in the healthcare system. Slowly, we’ve been moving in the right direction, but even without health reform mandates, hospitals and physicians increasingly expect that technology will play a vital role in the evolution of healthcare business models. And no matter what we want to accomplish in a reformed system, from improved safety to a more cost-efficient supply chain, information technology plays a significant role.

Successful technology implementation is “culture and process dependent”
You can install the latest, most dependable computer systems and the implementation will be deemed an utter failure if no one uses it or, worse yet, the technology impedes or conflicts with the ideal workflow of your business. From a technical standpoint, the implementation was a success. But from a business standpoint, it’s a strategic blunder that could cost millions, damage the reputation of your organization and, in the healthcare environment, put patients at risk. The other dimension to this issue is more about people than processes, and it can be summed up quite simply: People are more inclined to change when they have something to gain from it. Every component of healthcare delivery at your organization should be examined for ways to improve, and your staff, from the management team on down, is best equipped to identify opportunities. Many of these opportunities lend themselves to the thoughtful application of information technology. When people stand to gain something, they are more likely to cooperate, and support change despite differing reasons for wanting that change. In short, re-designed culture and processes logically precede the application of technology, which should be in an enabling role.

Successful cultural and process change is “leadership dependent”
An organization’s culture and business processes don’t change by themselves, certainly not if there is a specific direction or outcome desired. They can drift over time, but generally the changes that occur in this way either reinforce the status quo or are shadow processes that are designed to circumvent the “official” workflow. If systemic change is cast as something “the IT department wants,” you will fail. Only the board and the CEO can endorse systemic changes within an organization in a way that opens everyone’s eyes to a rich assortment of inventive possibilities. Encourage everyone in your organization to think paperless. Then ask how technology can make that happen.

Successful reform then, depends then upon how well executive leadership prepares its organization to embrace technology as a resource, not as the solution.

-Rod Piechowski

Copyright © 2010, Rod Piechowski, Inc., Consulting

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