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Implementation of Effective Change Management for Successful Integration of Health Information Technology (HIT) Systems in Hospitals

In Brief: This study identifies change management strategies needed for the CIO to successfully implement ICT systems in hospitals. Szydlowski and Smith (2009) state that the CIO must function as a technology leader and be able to demonstrate change management and leadership skills. Jaciute (2009) proposes that as an IT leader, it is necessary for the CIO to understand that early involvement of stakeholders and especially end users into the specification and development stage of any IT system is a key success factor for complex IT projects.

Technology has demonstrated potential to provide a positive impact on the delivery of healthcare in a number of ways.

Specific focus is placed on change management strategies related to integration of two pre-selected health information technology (HIT) systems: (1) electronic medical record (EMR) systems and (2) computerized physician order entry (CPOE) systems. These two systems have been identified as key collaborative components of ICT in hospitals. With these HIT systems in place, Tsiknakis and Kouroubali (2009) predict that the CIO and CMIO will see an increase in productivity, costs controlling, and care improvement.

This review of literature is organized around three major themes: the role of selected HIT systems in hospitals, the two pre-selected HIT systems (EMR and CPOE), and change management strategies for successful integration of HIT in hospitals. The first theme is structured to examine problems to be addressed by implementing HIT: definition and requirements. The second theme examines the use and impacts of two pre-selected HIT systems (EMR and CPOE) and the potential benefits of each selected technology to stakeholders. The third theme is framed to examine known barriers when IT leaders integrate HIT systems in hospitals, potentials benefits of selected change management strategies to overcome barriers, and necessary skills for application of these strategies.

Component Role
HIT Systems
  • Support effective information management
  • Support design and implementation of information systems that enable better decision-making
  • Support improvement of operational efficiencies, minimizing errors, reducing costs
  • Support resolution of ongoing problems such as the rising number of medical errors, poor health service quality, care fragmentation, and limited access and integration to patient information
Management Leadership
  • Master and adapt the technologies and collaborate with those who create them
  • Develop trust and respect among staff to facilitate higher level of employee commitment
  • Develop sound technical, organizational, project management, and interpersonal skills
  • Cultivate ability to constantly and rapidly shift between these skill areas on any given day
Change Management Strategies
  • Collect and analyze information security metrics
  • Establish benchmarks and targets
  • Communicate information and analysis, so others see the logic of change

Table 1—summarizes the key components necessary to implement effective change management for successful integration of HIT systems in hospitals.

In relation to the value of change management strategies for success, literature reveals that one of the most important methods to overcome resistance to change is to communicate about it beforehand. Communication of ideas helps people see the need for and the logic of a change, especially when resistance is based on inadequate or inaccurate information and analysis. When people fail to develop the coalition needed to guide change, the most common reason is that they really do not think a transformation is essential or they do not think a strong collaboration is needed to direct the change. To empower people to effect change, organizations need to communicate a reasonable vision to employees, provide training that the employees need, and align information and systems to the vision. Kotter (2002) further explains that trust and a common goal are crucial components for building an effective collaboration as they bind individuals together on guiding change coalitions. With the right structure, training systems, and supervisors to build on a well-communicated vision, increasing numbers of organizations are finding that they can tap a large source of power to improve organizational performance.

References

  • Juciute, R. (2009, January). ICT implementation in the health-care sector: effective stakeholders' engagement as the main precondition of change sustainability. AI & Soc, 23, 13-137. Retrieved March 31, 2009, from SpringerLink.com
  • Kotter, J. P. (2002). The heart of change: Real-life stories of how people change their organizations. Boston, MA: Harvard Business School.
  • Kotter, J. P., & Schlesinger, L. A. (2008). Choosing strategies for change [Electronic version]. Harvard Business Review Article. Retrieved May 3, 2009, from Harvard Business Review
  • Paul, S. A., Reddy. M., Abraham, J., & DeFlitch, C. (2008). The usefulness of information and communication technologies in crisis response [Electronic version]. In AMIA Annual Symposium Proceeding 2008, 561-565. Bethesda, MD: American Medical Informatics Association.
  • Szydlowski, S., & Smith, C. (2009). Perspectives from nurse leaders and chief information officers on health information technology implementation. Hospital Topics, 87, 3-9. Retrieved March 30, 2009, from EBSCO Host
  • Tsiknakis, M., & Kouroubali, A. (2009). Organizational factors affecting successful adoption of innovative eHealth services: A case study employing the FITT framework [Electronic version]. International Journal of Medical Informatics, 78, 39-52. Retrieved April 3, 2009, from ScienceDirect.com
AIM alumnus Pattarin Mekanontchai

Research Paper Author: Pattarin Mekanontchai, Thompson Metal Fab, Inc.—2009 AIM Graduate

Abstract: The purpose of this literature review is to examine change management strategies that chief information officers (CIO) and chief medical informatics officers (CMIO) need to understand to best implement health information technology (HIT) systems to effectively produce health services in hospitals. Two systems are examined: electronic medical record (EMR) and computerized physician order entry (CPOE). Leadership is the essential ingredient. Three key methods are identified to combat resistance to change: communication, collaboration, and empowerment.

Download the entire Capstone research project

AIM alumnus Jon Dolan
Jon Dolan (’13)
Jon Dolan (’13) received the 2013 Capstone Award from Dr. Linda Ettinger for his research paper Enterprise-Wide Techniques to Manage E-mail Overload at the AIM graduation luncheon.