The #1 Challenge When Implementing an E-Referral Solution – Change Management

Often, when different health care jurisdictions look at implementing an e-referral solution, they look at the technical specifications of the different solutions available but they do not pay enough attention to the human side of the equation.  Therefore, it is not surprising that the biggest issue all jurisdictions face when implementing an e-referral solution is change management.

Implementing an e-referral solution would be simple if the clinicians were automatons: you just simply reprogram them and then you’re done.  In reality, those who are responsible for providing care for patients have their own ideas on how the process should be implemented.  It’s the clinicians that need to be convinced that this new “e-referral” solution will improve the lives of their patients and be time and cost effective for themselves.

Within the healthcare sector, there is a high level of change fatigue such that adding another system is not typically met with resounding cheers.  From EHR systems to technology upgrades, it seems like many healthcare jurisdictions are going through a constant state of change.  This fatigue causes many jurisdictions to either delay or avoid implementing an e-referral solution.

Kevin Jones, Vice President of Client Solutions, Strata Health, points out that “Clinicians’ day-to-day work is focused on patients…. and over the short term, introducing systems typically takes away from the time they can spend working with patients.  This can create significant negativity if not handled correctly.”

It’s only natural.  It’s human nature to fear change.  So when they are faced with the proposition of moving away from the systems and processes that they have become comfortable with to one that sounds great but has an element of the unknown, people naturally fear it.

Streamlining the communication gaps in your patient flow process is exactly what an e-referral solution does.  An effective e-referral solution allows for improved communication through more effective workflows and data integration so that patients move through the system more efficiently and health care jurisdictions operate at a higher level of efficiency.  This does not mean that these jurisdictions need to implement a completely new workflow.  An effective e-referral implementation requires that everyone understands that the new e-referral solution should be built around the best practices of the health-care professionals, not the other way around.

Melissa Chouinard, Director, Client Services, Strata Health, points out that “usually the CEO or senior manager has a vision and will advise the operational staff that they need to make this software happen.  In the cases where the benefits and the vision are shared, there is more adaptability than in organizations where they are not shared.  In many cases, the operational level does not realize the effort it requires to make this change happen.”

That is why in order to have a successful e-referral implementation, all the stakeholders need to be brought on board at the beginning of the project.  Health-care employees, from nurses to clinicians to specialist, all have ideas about how to build a better e-referral system. However, to get buy in from everyone you need to involve everyone, especially the lower-ranking employees, you’ve got to invite them to be part of the planning process, not just expect them to execute the result.

Jen Hoecht, Senior Implementation Specialist, Strata Health, points out that “e-Referral implementations can span many organizations in a health region, and each organization can have diverse stakeholder groups with competing priorities.  The key to addressing these challenges at all levels is to identify benefits for all stakeholders and execute a well-defined communication plan to avoid surprises.”

Hoecht also points out that it’s impossible to over communicate.  Never assume that information passes within or between departments, organizations or health regions.  Misinformation is sticky.  Manage this with carefully designed, executed and synchronized change management, communication, training and rollout plans.  While strong leadership is very important to any change process, communication throughout the whole processes is usually the difference between a successful e-referral implementation and one that is destined to continuing challenges.

Rogan McGuffin, Client Services – Implementations, Strata Health points out that the most important challenge to overcome in these types of implementations is breaking down the barriers within and between organizations.  The typical structure of healthcare organizations is that each department is it’s own separate fiefdom, each with their own budget, goals and processes.  In order to make an implementation a success, it is vitally important to understand the drivers behind these differences.  If you can understand why these organizations have come to such disparate points, then you can begin to bring them back in line.  Ultimately, everyone in this industry has the same goal: patient care.  By focusing everyone on that goal, you can overcome all of the other challenges that arise.

David McDermott, Reporting Lead, Strata Health, adds that since an e-referral solution impacts multiple organizations, creating a common governance structure and identifying ownership of the system is a challenge.  During both the project phase and post go-live, a strong steering committee with adequate representation from all organizations must be active.

A strong communication plan that has been developed with buy-in from all levels of the health care jurisdiction is key to a successful e-referral implementation.  People fear change, so in order to dispel their fears with a new e-referral system, you need to communicate effectively.  This is only achieved when you have engaged all the parties involved or those affected by the change in referral systems and processes.  While change management is the biggest challenge faced when implementing an e-referral solution, a well thought out communication plan that has all levels involved in the planning process will ensure successful implementation.

To learn more about ways to improve your eReferral process download The Healthcare Executive’s Guide to Accelerating the Value of Health Information Exchanges with Resource Matching and Intelligent eReferral and download Implementing a Web-Based, Intelligent Care Coordination Solution for Behavioral Health Services to look at how a large regional health system in British Columbia, Canada, recognized the pressing need and opportunity to better coordinate care transitions for its behavioral health patients.

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