Warren Buffet, the famous investor, once said, “In a chronically leaking boat, energy devoted to changing vessels is more productive than energy devoted to patching leaks.” Mr. Buffet’s success is due to his ability to adapt and change when faced with a failing investment strategy.
Yet, humans are very resistant to change. By virtue of their profession, clinicians want to protect patients: to do no harm. They always wish to avoid bad outcomes, primarily when caused by new approaches or treatments. Their fear of causing a bad outcome tends to make them resist change. They almost always lean toward using the diagnoses and treatments they already know. The most reliable predictor of a physician’s practice pattern is the institution where they completed their residency training.
Yet everyone knows that there is likely a risk-reward balance in any situation. What if two physicians—a cardiologist and a cardiac surgeon—argue whether a procedure will succeed or cause more significant harm? Which procedure has the chance of producing the most favorable outcome? As the surgeon is operating, will she decide? Can they agree? If not, would the surgeon agree with another opinion? Who in this scenario must change?
In building your skunk works team, you need lieutenants to implement change. It would help if you enlisted others who, like you, regard this transformational change as essential and achievable. Everyone must keep an open mind, suppress judgment, and seek honesty and truth in what they are doing. Yet, to achieve these human attributes, it makes the most sense to base your decisions on objective scientific facts. That must always be the basis for your analysis and path forward, forming the game plan for revolutionary change. A demonstrable scientific basis is the most compelling motive for convincing others to participate.
A revolution in changing healthcare must involve HIT personnel. They are also scientists and IT professionals and are, by virtue of their nature and occupation, agents of change. They can provide a proof of concept. HIT also has the tools and skills to establish the scientific basis for the changes we need in your healthcare organization. This work has many facets—changing personal opinions and attitudes, devising new processes, overcoming institutional, political, and regulatory hurdles—and scientifically proving the need and methods for change. It will take time and effort, but it will be worth it.
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