Change can be slow. For example, it took well over a century for the humble medical thermometer to be widely introduced into clinical practice.1
However, health and other service delivery industries are now being disrupted by rapid and transformational technological improvements that are changing traditional clinical service delivery models on a global scale. In the healthcare sector, this is typified by increasing research into and experimentation with disruptive technology such as artificial intelligence, precision medicine and deep data utilisation. These advances, once implemented, contribute to the ongoing transformation of how healthcare is understood and delivered.
Disruptive technologies have the potential to greatly improve the safety and quality of service delivery by increasing the pace at which improvements can be implemented in practice, standardising processes based on recognised best practice, and improving equity of clinical care and patient outcomes across large geographical regions.
Despite these benefits, the identification, rollout and ongoing maintenance of new technologies can be extremely challenging, particularly for industries that have operated in the same manner for long periods of time. Leaders of organisations and teams that will be heavily impacted by new technology face significant issues with regards to ensuring the successful rollout of a disruptive technology and managing the transition of the business to incorporate the new service delivery model on an ongoing basis.
Challenges following transformational change
Issues faced by leaders during and following a transformational change, particularly for industries that have operated in the same manner for long periods, can include:
- pre-existing organisational and staffing structures that are incompatible with the new system, resulting in reactive structural amendments. This also results in employee confusion with regard to their role in the post-implementation organisation and can lead to intra-organisation territorial disputes, reduced communication and departmental silo building
- detachment of senior executives and the board, which can indicate a lack of importance for the project, and reduce the likelihood of success
- early or unexpected departure of staff at or nearing retirement age, or those who have been considering a move to a new organisation. This can be due to a large-scale change acting as a catalyst for staff who had been considering leaving at some point and can result in large losses of corporate memory and experience
- frustration by users of the system during rollout and troubleshooting, and ongoing discontent should the system not meet user expectations or previously stated organisational benefits
- confusion as to how users of a technology can provide constructive feedback as to how it can be improved to improve user and consumer experience. This can result in inefficient or unsafe workarounds for defects that become standard operating procedure over time
- a disconnect between technical staff that maintain a system, and those who use it.
- suspicion of the new technology, particularly as to how it will impact on job security, resulting in the potential for increased industrial action, adverse press or poorer relationships between management and staff. This is particularly pertinent as white collar (and white coat) industries are increasingly targeted by disruptive technologies
- a failure to ensure that rollout and implementation are on budget, on time and meets executive and board expectations.
A failure to achieve rollout or to integrate a technology into the business can result in decreases in key business measurable such as safety, quality, efficiency, effectiveness and of course the financial bottom line.
Suggested strategies for success
The transition to a new service delivery model using a new technology can be a significant expense to an organisation. A failure to achieve rollout or to integrate a technology into the business can result in decreases in key business measurables such as safety, quality, efficiency, effectiveness and of course the financial bottom line. Multiple strategies must, therefore, be used to mitigate the significance and likelihood of these risks eventuating, through the application of good planning, governance and change management techniques.
These should include:
- consideration of whether a business unit or organisational structure will continue to be appropriate given the introduction of the technology, and subsequent changes to the way services are provided. These changes are unlikely to be static, and may flow to other areas of an organisation, requiring both horizontal and vertical planning as to where changes to structure are required, and ongoing executive oversight and input
- clear and consistent executive support for the technology and change. This is imperative to mediating cross-organisational boundary issues, ensuring that costs do not overrun, and milestones are completed on time2
- clarity as to roles and responsibilities with regards to the usage, design, upkeep and improvement of the system, and the business as usual processes that maintain the system. This requires clear delegation of responsibility and the maintenance of good relationships across organisational boundaries, to ensure that the identification of improvements and defects are encouraged, and can be quickly acted upon. It also requires a degree of flexibility to ensure that structural issues can be efficiently escalated and resolved across organisational boundaries
- clear enunciation of the long-term benefits of the new system for the organisation over the current system, particularly how the system will benefit staff and customers. This must be tempered by honesty as to the limitations of the system when compared to current processes, clarity as to the timing of rollout and implementation, and ongoing empathy with staff and unions as to the difficulty that will likely be experienced during a transitional period. The needs of these groups should be carefully considered and responded to throughout the change process
- identification and on-boarding of early adopters who can act as influencers to other staff. This is key to ensuring that there is a critical mass of users that act as vocal supporters for the change, and reduce overall resistance. The reverse aspect to this is identifying staunch resistors, and developing strategies to convert them to the change, and failing that to mitigate potentially destructive tendencies
- ensuring that appropriate training is provided to users of the technology, including scenario-based training where possible, to ensure that go-lives occur with minimum disruption to service delivery, inappropriate workarounds are identified and minimised, and users do not revert to pre-existing systems or workflows over time
- ensuring that suppliers of a technology or service have methodologies to improve their systems based on the needs of the client on an ongoing basis, so that best practice changes can be reflected in the system.
While large-scale technological and process changes can be daunting, at times they are necessary to ensure the ongoing viability of a service model, or to provide the services expected by modern customers. Understanding of the risks that accompany these programs of work, and the types of risk mitigation strategies that should be considered at an executive level, are key to increasing the likelihood of a successful rollout, as well as the realisation of the long-term benefits that are made possible by implementation of a disruptive technology.