Managing organizational change in telemedicine-based home care delivery

Organizational Change Management Plan

The pervasive adoption of home care treatment programs over their more costly and less flexible institutionalized counterparts is forcing rapid change throughout the healthcare industry. Many of these changes are predicated on serving the patient more effectively, and this often encompasses their treatment programs, the level of patient satisfaction attained with their remote care, and the effectiveness of remote support and treatment from trained healthcare professionals. Telemedicine's potential to significantly improve patient outcomes is showing significant progress and is increasingly monitored as a quality management program using Six Sigma for example (Yun, Chun, 2008). Seeing remote healthcare in homes via telemedicine and ancillary technologies requires the healthcare professionals supporting these systems to change their perception of their jobs, how they evaluate their roles, and what excellence in their professions are.

Monitoring Implementation of the Change Management Plan

The shift to telemedicine-based homecare delivery systems that rely on patient record management systems also introduces the issues of security and privacy both for the treating physician and staff, and for the patient as well (Gritzalis, Katsikas, Keklikoglou, Tomaras, 1992). While the economics of telemedicine and homecare delivery will accelerate their use, just as any technology that reduces capital expenses gains momentum over time (Benamati, Lederer, 2000) there are unique, challenging and very difficult problems ahead in terms of managing the change these systems are the catalyst of, both for the healthcare professional and the patient. The intent of this organizational change management plan is to define the methods that will be used to monitor the implementation of the proposed change. Fortunately there is a continual emphasis and investing in techniques that measure the performance of healthcare systems and treatment plans while also measuring patient outcomes and satisfaction levels (Yun, Chun, 2008). The combining of Six Sigma quality management techniques and SERVQUAL, service quality management research methodology, are the methods that will be used for monitoring the implementation of the proposed change (Ladhari, 2009). SERVQUAL is highly effective in determining the relative level of both healthcare provider and patient results achieved and satisfaction levels with changed treatment programs. The SERVQUAL methodology has been used extensively throughout healthcare facilities and treatment programs to measure overall program effectiveness (Lam, 1997). Its five core attributes of tangibles, reliability, responsiveness, assurance and empathy are integrated into the broader SERVQUAL framework to ensure a 360-degree view of the patient, the hospital or treatment staff, and the results achieved (Ladhari, 2009).

Healthcare providers are increasingly relying on Six Sigma and its DMAIC (Define, Measure, Analyze, Improve and Control) methodology to track process-related performance gains over time (Yun, Chun, 2008). With the shift to home-based healthcare provisions away from institutionalized ones, there will initially be confusion over roles, responsibilities, which patient information systems to use when, and for what purpose. There is also going to be a significant level of anxiety over the change from institutionalized to home-based healthcare through the use of telemedicine-based systems. Exacerbating these changes will be the continual anxiety of healthcare center employees for their jobs, if and when a loss of status will occur due to the shift in healthcare focus, and the inclusion of advanced measuring techniques including SERVQUAL and Six Sigma. When there is a combined change in status within a healthcare organization as evidenced by a shift in information resources followed by the redefining of priorities, resistance to change often flourishes (Chatterji, 1996). These two measurement techniques will cause significant anxiety throughout the healthcare provider, as will the measurements being used to evaluate their performance. In conjunction with the SERVQUAL and Six Sigma techniques for evaluating the telemedicine-based program, there will also need to be entirely new sets of analytics, key performance indicators (KPIs) and metrics to evaluate their success as management will look to its investment in technologies and technologies for significant process-based improvements (Beaubien, 2013). This will undoubtedly create greater stress for the healthcare providers' employees as the related processes, systems, personal and professional roles become significantly modified over time. The next section of this analysis discusses how the organization's related processes, systems, personal and professional roles will change based on the introduction of an IT patient record management system that enables telemedicine-based delivery of home-based care to be achieved.

Analysis of the Organization's Related Processes, Systems, Personal

To Address Implementation Issues

What is most critical in any change management plan is the approach senior management takes to championing the change necessary for a project to succeed. For this specific change management plan that includes both the adoption of an IT record management system and the increased use of telemedicine-based delivery to streamline treatment to patients, the senior management team must be galvanized in its commitment and shared vision of the project. Best practices in change management necessitates that senior management make it very clear, and continually provide updates, on just what is happening with the IT patient record management system (Xirasagar, 2008). These senior managers must also work with the project leaders to ensure that everyone affected by the system change also has an element of control in how the system operates and specifically how the applications they rely on to do their jobs operate (Bloodgood, Salisbury, 2001). By taking this approach to designing the new system, the senior management and project management teams will have given the employees most affected by the change ample opportunities to trust it, and also modify it to reflect their individual preferences and needs (Chatterji, 1996).

In addition to these factors, the senior management team must concentrate on creating a high level of trust in the two methodologies that will be used for evaluating the performance of these systems. Both Six Sigma and SERVQUAL

are essential for measuring patient outcomes and also defining the overall level of patient satisfaction achieved. The defining of performance benchmarks for these systems must be a shared task or responsibility throughout the company if these two approaches to elevating performance are to succeed (Beaubien, 2013). Finally the integration of Six Sigma and SERVQUAL results to evaluate both the overall performance of the treatment programs and IT systems performance areas must also be included in the change management program to reflect the information needs of the employees and healthcare professionals using them as well (Lam, 1997).