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Despite the focus on innovation in healthcare, implementing change remains a challenge. Busy schedules, competing priorities, and comfort with the traditional way of doing things make it challenging for physicians to adopt and embrace changes to their clinical practice.

Six months after implementing Zocdoc for patients in Indiana (implementing online booking for hundreds of providers), I sat down with Dennis Murphy, CEO of Indiana University Health. We talked about their approach to improving access to care for patients — and how they work with physicians to manage the change that comes along with innovation. At IU Health, physician leaders encourage cultural change from within their organization, rather than forcing change from administration, with a lot of learnings along the way.

Below are some excerpts from our conversation.

On taking advantage of physician leaders to facilitate change:

Dennis Murphy, CEO, Indiana University Health: “One of our biggest challenges introducing Zocdoc was converting a skeptical physician audience. It came in different shapes and forms. Individual providers were worried about what this level of openness would mean for their own schedules. Some were afraid that they were going to be overrun with patients. Some worried that the wrong types of patients would book the wrong specialists. Would they be able to manage their work/life balance? If you filled up their schedule with scheduled appointments, how could they deal with urgent or emergent patients that were coming through the system? And so on.

There’s a way to manage communication, onboarding and access through the system. Our physician leaders worked to convert providers from skeptics to advocates, and then had those folks go out to talk to their peers about how it was working, instead of saying this was the brainchild of someone in administration and introducing the change from the top down. This has resulted in physicians that have a very positive association with the idea of online scheduling, rather than a negative connotation.”

On developing physician leaders:

DM: “In physician cultures it can be hard to be an owner, instead of deflector. Doctors are trained to think infallibly. They have to be right 100% of the time. On the administrative side, I’d rather have people take risks, have accountability, and if something doesn’t work out, admit that they were wrong and go back and fix it — which is a hard thing to do when you’re a clinician.

I’m a really strong proponent of not just developing physician leaders but of this notion of dyad and triad management, where you pair a physician and an administrative leader or a physician, nurse, and administrative leader –  each of them brings a different skill set to problem solving and change management. That ultimately makes them more successful than if they were trying to innovate by themselves.

So my advice to people would be don’t ask physicians to be leaders in isolation – provide the support structures to help them.”

On cultivating innovation among physicians:

DM: “Our physician leaders are definitely innovators and they’re willing to try things in their practices that I don’t typically see in a lot of big physician groups. Part of that is a prior track record of success as they have been introducing different innovations in their practices –ranging from their compensation model, to the way that they see patients, to embedding behavioral health providers in their practices. They’ve been willing to try and do a lot of new things. Introducing online scheduling with Zocdoc wasn’t an isolated innovation, this was additive to a whole set of innovations they were taking on.

Leaders should be a strong voice asking are these things working, what is not, how can we modify and adapt to make them work. A good leader taking on innovations has to decide when the experiment is not working and when to put an end to it. Periodically, we’ve had to do that as well. But there’s nothing more powerful in our organization than really strong vocal leaders with track records of success, because that encourages trying more new ideas.  We’ve seen that throughout the system.”

To learn more about innovation at IU Health, you can read more of our conversation here.

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One response to “Navigating Change Management for Health Systems”

  1. Anne Bolger says:

    Great comments, Dennis. Sometime ago there was a study in Wisconsin. It was very interesting as they examined the variables important to their population. They identified issues with obesity, smoking, diabetes etc. they then implemented a systemwide strategic plan to address the various constituents. For example, the recommendations included that 25% of restaurants would have heart healthy menu items; or they offered various smoking cessation programs. A repeat study five years later revealed significant improvements. Your perspective of addressing issues both on the System and individual perspectives is a great strategic initiative. Keep up the good work!

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