The effects of HIT implementation - resistance to buy-in

Two words that I considered stressful were "GO LIVE".

The Go Live phase of any EHR adoption was met with various reactions - from excitement, because of the promise of efficiency and effectiveness in the practice of medicine and the revenue that follows or to the dread of disruption because of an unknown system that may jeopardize job security or loss of productivity.

Resisting change is a natural human tendency (Ricketts, 2008) and to address it also a challenge. The reason there is resistance to change is because of the uncertainty it brings. For Ricketts (2008) the only reason we will no longer resist change is when we are convinced that the situation will improve.

The transition from Resistance to Buy-In goes through six levels. Ricketts (2008) provides a table for us to understand the dynamics of this disagreement-agreement dichotomy let us consider the table below:

We must always help in protecting the patient-practitioner relationship. We may not be directly involved in this interaction, but our role is crucial just the same. Our role in removing the barriers to change are:

1. Encourage consensus building. Consensus building is a process involving a good-faith effort to meet the interests of all stakeholders and seek a unanimous agreement (SanPietro)

2. Encourage open communication to uncover any conflicts. Information that is shared freely and conflicts that are openly discussed and worked through builds or expands trust (Stark and Flaherty, 1999).

Reference

Ricketts, J., 2008. Reaching the goal. Upper Saddle River, N.J.: IBM Press, pp.265-266.

Stark, P. and Flaherty, J., 1999. The manager's pocket guide to leadership skills. Amherst, Mass.: HRD Press.

Toll, E., Alkureishi, M., Lee, W., Babbott, S., Bain, P., Beasley, J., Frankel, R., Loveys, A., Wald, H., Woods, S. and Hersh, W., 2019. Protecting healing relationships in the age of electronic health records: report from an international conference. JAMIA Open, 2(3), pp.282-290.