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
and Professional Roles
The current processes and systems in place are heavily oriented towards institutionalized medicine and treatment programs. As these systems have been in place for years there is a stability to them, their processes, the supporting systems and their integration points, and most critical to this analysis, the personal and professional roles of the healthcare professionals that rely on them daily. It is this last point that will be the most difficult to overcome as the healthcare provider adopts a more remote-based approach to home-based treatment programs through telemedicine. The introduction of the IT patient management system to support telemedicine-based treatments to patients located remotely will just make the amount of change all the more difficult.
The greater the level of information a person has in an organization, the more power they also have. When information systems are rapidly changed there is a corresponding shift in the balance of power throughout any company. This shift in power causes many employees to feel anxious, become threatened, refuse to cooperate and attempt to make the new systems and processes fail (Benamati, Lederer, 2000). It's often called resistance to change, yet it is more than that;' its fear of a loss of status and a loss of importance in the organization (Beaubien, 2013). Change management plans need to take into account both the explicit and implied roles of all people in the organization as each is affected by these systems either directly or indirectly as they complete their jobs' tasks and responsibilities.
Another aspect of these systems is that they are being evaluated in terms of performance in terms of streamlining internal processes and procedures within the healthcare facility today. The IT patient record management system had been a file drawer and is quickly moving to a single, unified system of record with all available data in it for each patient. The IT patient record management system also defines the success or failure of specific treatment programs as well. In other words, as the IT patient record management system becomes operational, the healthcare professionals will also be evaluated on this dimension of their performance as well. This adds to the anxiety of the change in their status. When all of these factors are combined it is clear to see why resistance to change is so pervasive throughout organizations attempting to automate their processes and become more cost-efficient while increasing patient satisfaction and success of treatment plans. What is essential for any organization going through this extent of change is to involve those most affected in each phase of the change management process (Chatterji, 1996). The project managers responsible for the IT patient record management system must concentrate on creating a deployment methodology that includes everyone affected by the next systems, including those who will need to rely more on telemedicine-based feedback on their job performance and less on iterative, face-to-face interactions with the patient. The point was made that the analytics, key performance indicators (KPIs) and metrics of performance will change when the IT patient record management system is installed, in conjunction with the transition tot the telemedicine platform and system as well (Beaubien, 2013). The employees of the healthcare provider need to be involved in the defining of these analytics, KPIs and metrics so they attain a level of autonomy, mastery and purpose over the changes taking place. These three factors are essential for long-term motivation to take effect are indispensable in any change management initiative and program (Bloodgood, Salisbury, 2001).
Communication Techniques That Will Be Used
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).