Implementing Healthcare Reform—Easier Said than Done!

Elizabeth ReganBy: Elizabeth A. Regan, Ph.D., Department Chair, Integrated Information Technology, Professor of Health Information Technology, University of South Carolina

The most recent survey of hospital CEOs conducted by the American College of Healthcare Executives reported that healthcare reform implementation is #2 on the list of most concerning issues.  And well it should be.  The record on innovation and change implementation shows that 75 percent of the time, initiatives fall far short of achieving the intended goals and some outright fail—even after investment of millions of dollars. This is especially true in the case of IT enabled innovation.

“Why is this the case?” you might ask.  For starters, implementation is just plain hard work– the effort and resources required tend to be grossly underestimated. It is not the ideas or the technology that lead to failure, it is the way in which the implementation is managed. Significant efforts go into planning, but all too often, sufficient resources do not follow and, even more critical, neither does the leadership of top management.  It all starts at the top.

Leadership is critical in an era of unprecedented change.  It is important to note that
management and leadership are not the same thing. Management focuses on controlling operations; leadership focuses on ensuring the future success of the organization. Management comes with authority; leadership requires followship, which cannot be mandated. Management strives for stability; times of uncertainty call for leadership. One does not necessarily lead to the other. Superb management of what we excel at today may blind us to what needs to be done to succeed in the new era of healthcare.  Research suggests that top management engagement is a key factor in successful innovation.

So what is the proper leadership role for top management in transforming healthcare?  Effective leaders are superb at connecting the dots. They paint the picture on top of the puzzle box in clear strokes that help people understand how the pieces fit together, where they personally fit in, and why the changes are critical to the future success of the organization. How do leaders accomplish that? The following factors would certainly be high on the list.

Be an Effective Advocate

Leaders must be effective advocates for change and the critical role of technology in achieving it. That not only means that they can clearly communicate how planned changes will lead to the intended outcomes, but they must also walk the talk. Effective leaders change their own behaviors consistent with new directions, and demonstrate, both symbolically and in reality, the benefits of new technology and new business practices. The ultimate arbiter of their success is the degree of buy-in and grassroots leadership they generate at the front lines. Remember, leadership requires followship, which cannot be demanded. Building buy-in is the number one role of an effective leader.

Establish the Right Priorities

Leaders establish the right priorities by focusing the organization on the right outcomes. Healthcare transformation must be driven by patient focus – not financial decisions. Why? Because ultimately meeting patient needs will lead to financial success; not the other way around. Today’s technology is empowering patients, and patient choices will drive financial success because patient choices will be based on value—a combination of quality and cost. Patients will migrate to the innovators who are best meeting their healthcare needs. The path to higher quality at reduced cost is through meaningful use of technology, not cost cutting measures. Innovation can lead to reduced cost, but it does not follow that cost cutting will lead to innovation.

Focus on Integration

Top management leadership is also critical because successful change requires a systemic approach, which must come from the top. Innovation projects carried out in silos do not necessarily add up to clinical transformation. In fact, silo projects are difficult to sustain long term. The power of health IT derives from the capability to more effectively and efficiently integrate services across the continuum of patient care. Leaders who understand the power of using technology to share patient information and engage patients in new ways through telemedicine, mobile apps, patient portals, and other innovations, recognize that these changes will pervade every aspect of their operations. It is not feasible to change one operation without affecting many others. Top management’s challenge is in fostering the necessary culture of innovation that engages people throughout the organization in embracing the technology and process changes essential to improving quality and lowering the cost of care.  Execution requires commitment and resources that can only come from the top.

With a focus on these factors, leaders can greatly improve the likelihood of achieving the intended outcomes from innovation initiatives, which will surely be a win for everyone in the future.




About Ethan Baron

Program Manager, Innovation, Healthcare Information Systems, HIMSS
This entry was posted in Health reform, Innovation and tagged , . Bookmark the permalink.

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