Over the past decade, there have been many improvements in the healthcare industry. The number of different healthcare technologies used across hospitals is immense. Many of these technological advances have streamlined workflows, brought efficiencies to processes, improved patient safety and care, and reduced clinical workload.
In the face of these transformational advances, healthcare technology adoption continues to fail at an astounding rate. Studies vary, but some estimates of health IT implementation failures are as high as 70 percent.
I started thinking about why some projects are successful and others aren’t. Budget and technical issues, of course, are significant factors.
However, the failure to incorporate human considerations into technology evaluation, implementation and training is worth exploring. I believe the failure of the adoption of any new technology relies on a few basic factors:
If a technology alleviates a problem nurses are experiencing—without creating new ones—they will likely recognize its value, embrace the technology and may even champion it.
Consider medical devices with alarming capabilities. Nursing staff are charged with the proper setting of the alarms and the interventions whenever a device sends an alert. As the alarm-enabled technology proliferates, nurses find their workflow and ability to engage with patients subsumed by hundreds of (often false) alarms. Without proper education and implementation, it’s all too easy to imagine clinical staff arbitrarily adjusting alarm settings or turning them off.
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One aspect of healthcare technology implementation that is often sidelined is the impact on clinical workflow. Health systems leaders should incorporate clinical workflow as quickly and as early as possible in the implementation process. Technology implemented with the end-user in mind is a great way to ensure high adoption rates.
Clinicians will reject technologies that do not align with their day-to-day activities, improve patient care or enable them to work more efficiently. In my experience working in hospitals, I’ve observed nurses and doctors ignoring new technology, programs, and applications until they have no other choice.
Additionally, understanding how clinicians absorb new technology into their individual workflows will help define the kind of training needed. For example, new nurses are digital natives. Their familiarity with information technology practically started in the crib and today they incorporate information technology into their everyday life.
However, this comfort level is not true across the board. Fear of change, of losing control or making mistakes can doom the adoption of new technology.
When I worked on a telemetry unit, an older cardiologist would always ask me to enter orders for him in the computer. Each time he would use a different excuse—he didn’t have his glasses or his fingers were too big for the keys. I soon realized that he was afraid to use the computer. I don’t believe that he ever took any of the in-service training sessions because he was afraid of failing in front of others.
Any technology champion or implementation team has to understand and respond to the fact that we live in an age where technology advances can often far outpace our ability to comfortably integrate them into our daily lives.
Many of these issues can be mitigated with adequate planning, training, and collaboration. By listening to, engaging with, and educating front-line staff, hospitals can dramatically increase their chances of success with healthcare technology adoption.
Hospitals each have their own unique characteristics and needs. Identifying and documenting those attributes are critical to implementation success. To achieve measurable progress in health IT adoption requires that hospitals identify and support cross-disciplinary champions, including IT networking, facilities, patient safety experts, educators, informatics nurses, laboratory staff, pharmacists, electrical engineers, biomedical engineers, quality improvement specialists, vendors, and patient-facing clinical staff.
This team will be responsible for every phase of deployment—acquisition, rollout, implementation, and transition to live operations. They will determine the hospital’s objectives and integration goals, as well as vendor evaluations, business and clinical requirements, risk management concerns, patient safety goals, and costs.
Designating a nursing champion—or super-user—at the outset allows other nurses and patient-facing clinical staff to receive information, training, and support during all phases of adoption. These super-users would be working closely with the interdisciplinary team assembled for the implementation project.
A team approach to health IT doesn’t guarantee that technology adoption and implementation will be a success—but it will significantly increase its chances of sustainability. Today’s nurses have neither the desire nor the option to be passive consumers of healthcare technology. The seamless integration of technology requires that patient-facing clinical staff have influence in the design and testing of equipment and applications. Involving end-users in the early stages of system analysis and design specifications can lead to better adoption of new technology, as well as identifying how current technology can be adapted for greater user acceptance.
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