Application: Adoption of New Technology Systems
As a nurse, you can have a great impact on the success or failure of the adoption of EHRs.
It is important for nurses to understand their role as change agents and the ways they can
influence others when addressing the challenges of changing to a drastically different way
of doing things.
Everett Rogers, a pioneer in the field of the diffusion of innovations, identified five qualities
that determine individual attitudes towards adopting new technology (2003). He theorized
that individuals are concerned with:
Relative advantage: The individual adopting the new innovation must see how it will be an
improvement over the old way of doing things. Compatibility with existing values and
practices: The adopter must understand how the new innovation aligns with current
practices.
Simplicity: The adopter must believe he or she can easily master the new technology; the
more difficult learning the new system appears, the greater the resistance that will occur.
Trialability: The adopter should have the opportunity to ‘play around’ with the new
technology and explore its capabilities.
Observable results: The adopter must have evidence that the proposed innovation has been
successful in other situations.
For this Assignment, you assume the role of a nurse facilitator in a small hospital in upstate
New York. You have been part of a team preparing for the implementation of a new
electronic health records system. Decisions as to the program that will be used have been
finalized, and you are now tasked with preparing the nurses for the new system. There has
been an undercurrent of resistance expressed by nurses, and you must respond to their
concerns. You have a meeting scheduled with the nurses 1 week prior to the training on the
new EHR system. Consider how you can use the five qualities outlined by Rogers (2003) to
assist in preparing the nurses for the upcoming implementation.
To prepare:
Review the Learning Resources this week about successful implementations of EHRs.
Consider how you would present the new EHR system to the nurses to win their approval.
Reflect on the five qualities outlined by Rogers. How would addressing each of those areas
improve the likelihood of success?
To complete:
Write a 3- to 5-page paper which includes the following:
Using Rogers’ (2003) theory as a foundation, outline how you would approach the meeting
with the nurses. Be specific as to the types of information or activities you could provide to
address each area and include how you would respond to resistance.
Analyze the role of nurses as change agents in facilitating the adoption of new technology
Reference:
Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York, NY: Free Press.
A Focus on the Adoption of Electronic Health Record Systems in a Hospital
The evolving concept of electronic health record systems, EHRs refers to the systematic
electronic collection of patients’ health information such as demographics, medication, allergies
ADOPTION OF NEW TECHNOLOGY SYSTEMS 2
medical history, immunization status, radiology images, laboratory test results, vital signs as well
as personal information (Blumenthal et al, 2008).The records are kept in a digital format making
it possible to be shared among various healthcare settings through networked information
systems capable of handling wide range enterprise information or other means of information
exchanges (Chun-Ju & Esther, 2012). Despite their great potential to enhance healthcare services
delivery, physicians in the US have been reluctant in adopting EHRs. The top barriers to
adoption of EHRs, which have been the subject of undercurrent resistance by nurses in my
hospital, include: cost of EHRs, technical support to the system and ability to use the systems
(Nancy et al, 2009).
In order to achieve a successful implementation of EHRs in my hospital, I recognize the
fact that proper planning is essential. It is a large undertaking to fully implement an EHR for any
practice. Its success, therefore, depends on diligent planning from careful identification and
appointment of the project manager and team to outlining stages of implementation of the system
(Blumenthal et al, 2008). It will also be important to focus on the people as well as change
management in order to get the entire process on board and reduce the high failure rate
associated with most IT-related projects (Nancy et al, 2009). EHR is likely to change roles/duties
of the associated staff hence the anxiety and fear so far experienced due to anticipated culture
practice change. The concerns of the nurses must therefore be addressed in an open manner for
them to understand that the change will be in their best interest (Chun-Ju & Esther, 2012).
The nurses will be among the key stakeholders in the implementation and use of the
EHRs. As a result, it is important to win their approval of the new technology which is the
subject of the pre-training meeting. First, individuals are often concerned with the Relative
advantage of a new technology in order for them to adopt it. One my key concerns will therefore
ADOPTION OF NEW TECHNOLOGY SYSTEMS 3
be to be to show them how EHR will improve record keeping as opposed to the old manual
system (Rogers, 2003). In this regard, I will highlight the vast problems associated with manual
heath records: manual data entry which subject to human error, cases of misplaced/lost files or
customers forgetting their patient numbers making it difficult to retrieve records, cases of
multiple entries of patients’ files and the need for a large administrative staff which minimizes
health service provision (Blumenthal et al, 2008).
The nurses’ concern about compatibility of the EHR with the existing values/practices
will also be addressed in order for them to comprehend how the new technology will align
systematically with their current practices (Rogers, 2003). I will therefore demonstrate to them
how EHR allows for documentation of interactions with customers, viewing of patients’ medical
histories as well as insurance information, making referrals, ordering of laboratory test exercises
and subsequent viewing of the test results (Nancy et al, 2009). I should also make them
understand that the EHR will allow for sending of prescription requests electronically to
pharmacies (minimizing the risk of misreading hand-written prescriptions thereby flagging
potentially dangerous drug interactions). It will also provide the doctors with tools for decision
support for instance clinical guidelines and drug interactions checks as well as post-visit print-
outs for patients (Rogers, 2003).
As it stands, the nurses are also concerned with their ability to use the new system. This
will largely depend on the simplicity of the chosen system. This must be addressed through a
careful selection of an appropriate system that will ease learning and mastery of the new
innovation by the adopters (Rogers, 2003). Research will also be carried out by the project team
to assure the adopters that the hospital will purchase high quality hardware which shall
efficiently support the EHR and ease use by adopters. A proper system selection procedure will
ADOPTION OF NEW TECHNOLOGY SYSTEMS 4
get us close to selecting a system which can be used without further modification. While it’s
often tempting to deem you require customization, this will invariably cost much time and
resources. Instead, I will focus the nurses more about learning the new system as originally
designed, only selecting from its available options (Blumenthal et al, 2008).
Adopters of a new innovation are often also concerned about the observable results of the
proposed system in order for them to contemplate adopting it. They need to have reliable proof
of success of t the proposed system other situations (Rogers, 2003). It will therefore be my
obligation to collect such evidence from successful adopters of a similar system to ascertain how
useful the system can be in our setting. It may also be necessary for my office to organize for my
selected project team a visit to a practice that has adopted the proposed EHR system. Such a
visit, if possible, may be necessary before the pre-training meeting so that I have a larger team
who understand the system at the meeting. This visit will give us a much better idea of how the
EHR system will really work other than rely on the vendors’ demonstrations (Nancy et al, 2009).
The outcome of the visit may also trigger further adjustment, if need be.
Finally, for a successful implementation of the new technology, it is important to train
and retrain the users over time (Chun-Ju & Esther, 2012). It will be my obligation to present to
the nurses and other stakeholders my hospitals’ plan and modalities to offer them this much
needed training. This assurance will likely enhance their confidence and acceptance of the
system. As stated earlier, introduction of the new system will completely change their practice
environment. As a result, change management will be a significant part and parcel of adopting
the new system (Rogers, 2003). Communicating the hospital’s case for such change will assist
the staff to understand the essence for the same. This will be best captured through a documented
vision statement. It will also be necessary for me to maintain communication with the staff
ADOPTION OF NEW TECHNOLOGY SYSTEMS 5
members all through the project cycle in order to continue identifying their perceptions and
possible sources of further resistance (Nancy et al, 2009).
In conclusion, an electronic health records system is an evolving technology that involves
collection of electronic health records of patients or populations. Such records are then stored in
a digital format which enhances their sharing among different users. The EHR systems have a
great potential to enhance healthcare services. However, their adoption faces resistance, which in
the case of my hospital, will be dealt with by addressing the concerns of my nurses on the
relative advantage of the proposed system, its compatibility with our practices, its simplicity,
trial ability as well as its observable results. Addressing these in the pre-training meeting and the
subsequent proper training is anticipated to win their approval and develop the nurses and other
staff into being super users of the EHR system.
References
ADOPTION OF NEW TECHNOLOGY SYSTEMS 6
Blumenthal, D., DesRoches, C. & Donelan, K. (2008). Health information technology in the
United States: the information base for progress. Princeton, NJ: Robert Wood Johnson
Foundation.
Chun-Ju, H., & Esther, H. (2012). Use and Characteristics of Electronic Health Record Systems
Among Office-based Physician Practices: United States, 2001-2012. Publications and
Information Products centre for disease control and prevention, 111, 32-36
Nancy, M.L, Angelina K., Don, E.D. & Meryl, B. (2009). How to Successfully Select and
Implement Electronic Health Records (EHR) In Small Ambulatory Practice Settings.
Medical informatics and decision making, 6, 23-32
Rogers, E.M. (2003). Diffusion of Innovations. New York, NY: Free Press.