NtC 30: Why We Need Both Evolutionary and Revolutionary Change

Evolutionary change is what happens to each of us all the time. Evolutionary change is gradual, often subtle, but essential to our growth. Revolutionary change is rarer, sometimes unexpected, and often results in a quick incremental change. We are more cognizant of revolutionary change when it occurs, perhaps as needed, but also because it is usually a disruption that messes things up.

The revolutionary change for HIT I am proposing is nearer evolutionary than the change forced by the French Revolution. In many ways, it is organic change, resulting from many culminating evolutionary events, such as a cure for cancer where new knowledge drives changes in treatment. A revolutionary change precludes possibilities from returning to the previous status quo. Yet revolutionary change can and should be managed more sophisticatedly than evolutionary change. Revolutionary change is the volcano erupting. Evolutionary change is the lava flowing down the mountainsides.

Here is a simple illustration of evolutionary vs. revolutionary change in IT:

Programming languages evolved from COBOL and Fortran to Java and Python and continue an evolutionary change, while fourth-generation modules are revolutionary leaps in programming ability and productivity.

There is no question that medical research has similarly evolved, steadily and progressively: organ transplants, stem cells, and gene therapy. Yet the immense challenges of the future are not so flashy but include increasing costs of care, clinician shortages, and expanding demand for care, which requires a different perspective on change for healthcare.

The term transformation is critical to understanding the difference between evolutionary and revolutionary HIT. Revolutionary transformations are soundly conceived and implemented with significant effect. They are good to go. They are the desired outcome of both evolutionary and revolutionary change.

My thesis for my book is, as stated before:

Revolutionary Healthcare Information Technology (RHIT) offers clinicians, researchers, and administrators immensely powerful tools to drive clinical and administrative processes to deliver high-quality, safe, accessible, and investment-responsible medical outcomes.

In summary, revolutionary healthcare information technology is a transformational change that incorporates both evolutionary and revolutionary change.


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