The development and implementation of new information management systems has become one of the definitive features of present-day health care system. New health information systems have profound impacts on the entire health care continuum. Nurses are the first to perceive the beneficial effects of new technologies and, at the same time, display resistance to the changes they believe to be dangerous for their professional and organizational position. Nurses are regarded as the major largest group of providers in any medical facility or healthcare organization, and their resistance to technological change can be quite frustrating (Warnock-Matheron & Hannah, 2000). Simultaneously, nurses are change agents and have the potential to facilitate the adoption of new technologies, when they see such change in a positive light (Finkelman & Kenner, 2013).
The process of adopting new technologies within organizations is costly and challenging. One of the biggest questions facing today’s health care professionals is why so many information management initiatives have failed. Very often, health care professionals and organizations cannot overcome resistance to technology change or fail to persuade their stakeholders to reconsider the proposed change from a more positive perspective. Rogers’ theory of diffusion of innovation provides some clues as to whether and why some information system projects do not fulfill their purpose. “It is suggested that five attributes of technological innovations correlate with their adoption including relative advantage, compatibility, complexity, trialability, and observability” (Rogers, 2003, p.26). These aspects of technology adoption can shape a perfect argumentative basis for healthcare leaders, who seek to convince the hospital nursing staff that the new Electronic Health Records system (EHR) will benefit them and their patients.
One of the primary arguments in favor of EHR is its relative advantage over the existing information management systems. However, objective benefits can be less important than nurses’ perceptions of the system’s main advantages (Sanson-Fisher, 2004). Therefore, it is essential that nurses view the new system as something that will benefit them personally. It is possible to tell nurses that in the first stages of EHR implementation they may face more work, but given the efficiency of the new system and its productivity gains, nurses’ workloads will decrease when the system is implemented. Nurses will end up with the workloads lower than the ones they currently face (Leonard, 2004).
Compatibility is another problematic aspect of technology change. Many nurses may view the new system as incompatible with their values, principles, and beliefs. They may not be willing to give up traditional processes and procedures, thus resisting to the easy implementation of EHR (Warnock-Matherson & Hannah, 2000). Still, this aspect of Rogers’ technology adoption process can be used to show how the new system is compatible with nurses’ workplace obligations. Moreover, it is possible to emphasize how the system will help nurses solve the most painful workplace problems. For instance, the EHR system will help reduce medication errors and prescription bureaucracy, thus being compatible with the principles of safety and beneficence that are so important to nurses.
Complexity and trialability often go hand in hand. Nurses can resist to the adoption of new technologies, because they perceive them as difficult in use or have little influence on the way the technology is developed and modified (Sanson-Fisher, 2004). More often than not, it is due to the lack of training that nurses perceive the new technology as inherently complex and unsuitable for use. Still, it is one week before the training course that the meeting with nurses will take place, and the nursing leader can try to persuade the staff that training will give them a better understanding of the technology, its convenience and simplicity. Also, in terms of trialability, nurses should be encouraged and empowered to report possible problems and recommend changes to EHR. Leaders can even organize a small technology trial to see how nurses cope with the system and identify its potential pitfalls.
Finally, adopting new technologies is impossible without making the results of such adoption more observable to stakeholders. Nurses must see that the use of the new EHR system actually benefits them. A teleconference with nursing leaders from other hospitals can become an essential part of the scheduled meeting with nurses. This is how nurses will see the positive impacts of EHR on nurses and patients. The more charismatic the nursing leader is the more likely nurses are to adopt the advocated technology change (Sanson-Fisher, 2004). However, the current state of research suggests that, of all communication channels, face-to-face exchanges are the most effective (Sanson-Fisher, 2004). Consequently, it is better to invite another nursing leader to attend the meeting with nurses and communicate the real benefits of EHR adoption to the nursing staff.
The role of nurses as change agents in the adoption of new technology should not be disregarded. Nurses cannot successfully cope with their obligations, if they do not engage in change (Finkelman & Kenner, 2013). Professional nurses have the potential to facilitate the adoption of new technologies, but only when they can see the proposed change in a positive light (Finkelman & Kenner, 2013). Unfortunately, in the discussed case, the decision to adopt the EHR system has been finalized, and nurses seem to have had no opportunity to impact the final decision. Nurses must see the value of EHR in order to become its facilitators. It is possible to assume that the meeting scheduled with nurses and its outcomes will play a crucial role in restructuring nurses’ attitudes towards EHR.
Nurses can be effective facilitators of technology change, but only when they can see such change in a positive light. Rogers’ five aspects of innovation diffusion can help nursing leaders persuade their staff that the implementation of EHR will benefit them and their patients. Unfortunately, it seems that the decision to adopt the proposed technology has been finalized, and nurses might have had little or no influence on technology adoption. Consequently, the nursing leader will have to provide compelling arguments to persuade the nursing staff that the new EHR system will reduce their workloads and enhance the quality of care provided to patients.