Monday, July 2, 2012

Last week, a few members of the HIT Standards and Policy Committees were speaking about the future stages of meaningful use and the pace which stakeholders will tolerate.

As we discussed change management strategies, someone mentioned the You Tube video of the Dancing Guy as a model for how groups react to a new idea.

The thesis in this 3 minute  is that the leader is not the catalyst for adoption, it's the first follower who validates the leader's ideas and creates a safe environment for others to join.

In college and medical school interviews, I was often asked "are you a leader or a follower"?  My answer at the time was "both - it depends on the situation and context".

The Dancing Guy video postulates another answer - you can be a leader by being a follower.

In my experience, this first follower phenomenon rings true.  

French historian Alexis de Tocqueville concluded that Americans are a country of joiners.   Once a movement starts building, we do not want to be left out.

Early adopters of EHRs were informatics types experimenting with new technology.  Once the tipping point (about 20% adoption) was reached, clinicians began demanding EHRs so that they would be seen as equals in the referral community.

Health Information Exchange is still in its infancy, but I'm beginning to see a tipping point there too.   Massachusetts goes live with a statewide Direct-based exchange on October 15, 2012.   Partners Healthcare, Children's Hospital Boston, Beth Israel Deaconess, Atrius and others have committed to be part of the "golden spike" events, exchanging data as the network is activated.   All it took was one influential follower to validate the desirability of participating and immediately other institutions wanted to become early adopters - part of the "in" crowd"

Thanks to the Dancing Guy for giving us the secret for successful HIE adoption.  Be a leader by being a follower and soon the entire community will join in.

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