Introduction

Adopting a new electronic health record has significant implications on the landscape of social change within healthcare set up and particularly in a small hospital as in this case. Electronic health records have the ability to address public and population information needs (Fickenscher & Bakerman, 2011). This way they facilitate delivery of health services in addition to enabling the government to be in a position of financing and developing sound health policies. Additionally, information that has been accumulated in the electronic health records (HER) can be used in promoting environments and health lifestyles of the public. More so, this information can be used to reveal how a disease is prevalent and as such provide a significant amount of data that can be used to develop strategies and policies for dealing with such situations (Fickenscher & Bakerman, 2011). However, implementing such a program in a hospital may not be easy particularly if it is met with resistance from nurses as it is in this case. Nevertheless, Rogers Diffusion of innovations theories provides certain qualities that can facilitate successful implementation of a change as outlined in this paper.

Diffusion of Innovations and how it can Facilitate Successful Implementation

Adoption of a new technology is influenced by the ability of the adopter to make a judgment of whether the benefits of using innovation will surpass the risks of using that innovation (Green, Ottoson, Garcia & Robert, 2009). The other factor that affects adoption of a new technology is whether that innovation will improve the existing technology. If people anticipate more benefits from adoption of the innovation, then diffusion of that technology will be rapid. This is what Rogers call relative advantage, one of the qualities that affect adoption of new technology.

Relative Advantage

Everett Rogers argues that relative advantage is expressed as social prestige, economic profitability, and any other benefits. Having a sophisticated technology is important to many hospitals so that they can be competitive. It increases prestige. Additionally, it would attract many innovative physicians. Patients too would aspire to be treated in a hospital that is well equipped (Gruber, Darragh, Puccia, Kadric & Bruce, 2010). To most patients, adequate health care services are equated to up to date technology. In this regard, EHR would project the image of the hospital as a reputable health system. As a facilitator who would want to see that there is full implementation of this new EHR system in the hospital, there is the need to understand who the end users of technology are. This involves identification of the persons who is measuring the benefits of the new adoption against other decision-influencing and decision-making entities. Convincing these people in implementation process would be a milestone to adoption.

Under this relative advantage quality, the next step would be to recognize the effects of behavior change (Gruber, Darragh, Puccia, Kadric & Bruce, 2010). As a facilitator, the ability to illustrate how the new technology would offer greater benefits if adopted would be important in easing tension and resistance from nurses. More so, considering the business case to embracing this new technology is paramount. This involves calculating return on investment to help the adopters and the parties involved in the process of implementation understand the tangible benefits of the new EHR to be adopted. Testimonies and success stories from those who have adopted EHR may affirm these tangible benefits

Trialability

The ability to try out a new technology with minimal investment and little commitment are what Rogers call Trialability (Green, Ottoson, Garcia & Robert, 2009).  If it is easier to try out a new technology without much commitment or heavy investment, then prospects for adoption will be better. Trying out a new technology or innovation would allow the adopters of it opportunity to reduce benefits and risks uncertainty. Even if some pieces of evidence argues against or for the advantages of adopting EHR, personal experience may overcome this if it is used well.

As a facilitator, therefore, it is important that one look for a chance to carve out any part of the system which is more trialable despite the fact that a new technology may not lend itself to trials. Dividing the whole process into components that can be tried without full commitment or investment would be helpful in convincing the parties involved in the process of implementation (McGonigle & Mastrian, 2014). Again, it would be useful at this stage to demonstrate the tangible benefits of this innovation and how more powerful they would be in the case of a complete system. Therefore, this quality demands one to try out the new technology with minimal investment and with a little commitment for the betterment of adoption prospects.

Observability

This involves seeing how the new technology is working by watching another person use it and after that acknowledge that the innovation is beneficial and safe (Green, Ottoson, Garcia & Robert, 2009). The ability to demonstrate the benefits of technology would augur well with nurses and reduce cases of resistance that may arise. If the evidence of increased functionality, improved experience, and better results can be achieved, then the likelihood of adopting the new technology for users increases (Kaminski, 2011). As a facilitator of seeing the successful implementation of this technology, making the invisible to be visible would be core. A challenge exists if one is not able to make an adoption that is non-observable to be visible. However, by focusing fully on the need to articulate the visibility of the new adoption and diffusion, one will win the support of the users of the new technology.

Compatibility

This defines the degree or extent to which innovation is seen as in line with the past experiences, needs, and existing values of the users (Hyrkäs & Harvey, 2010). Regarding increasing the likelihood of adoption, the new technology must address the issue that nurses see as a problem. Procedures and tests that are likely to offer solutions to nurses must be demonstrated. In this case, the benefits of EHR to the hospital must be spelled out clearly by demonstrating how the new technology would contribute to reliability, convenience and easy retrieval of information for public consumption. Easy retrieval of a patient’s data is compatible with quality services, and as such, it would pay if the new technology is adopted.

Complexity

This measures the extent to which the new technology would be perceived complex to use or understand it. A clinical product or procedure will be adopted if it is simple to use or understand. If a procedure is complex to use and understand there is a high probability of receiving resistance (Hyrkäs & Harvey, 2010). Training on a complex procedure may be unwelcome to nurses. It, therefore, requires simplification of any procedures or product before it can be introduced to health professionals. In this context, it would be significant first to simplify the contents, procedures involved and any specifications of the EHR system before it can be introduced to nurses. This would help quell any the current resistance from hospital nurses.

Nurses as Agents of Change in Facilitating the Adoption of New Technology

Nurses have a great effect on the failure or success of adoption of EHR. It is good that nurses understand their duties as change agents and how they can impact on others when addressing the various challenges that emanate from change. A nurse has the role of improving the process of implementing the new technology through engaging in research and being a visionary, idea person and a facilitator (Gruber, Darragh, Puccia, Kadric & Bruce, 2010). Being a visionary nurse would entail communicating, coaching and advising where necessary on how best to adopt the new change within the health care sector. To bring that change, it is important that a nurse act as a facilitator by educating others on why change is needed and demonstrating the tangible benefits of this new idea that is being implemented.

A nurse should function as a change catalyst. Through the provision of clinical expertise, commitment and theoretical expertise by nurses, the results of any project within the health sector is likely to be successful (Kaminski, 2011). Consequently, nurses should be in a position to evaluate, analyze, plan and implement the process of change in a diligent manner for the benefit of the hospital. Being an agent of change in the healthcare sector is one of the vital roles of nurses (McGonigle & Mastrian, 2014). Point to underscore is that change is a reality that is taking place almost every time and nurses should not be barriers to change rather; they should facilitate it. This is achievable if nurses put the focus on the safety of patients and the reliability of health care services.

Conclusion

Diffusion of innovation depends on ideas being passed from one person who knows about the technology or innovation to another individual who is not aware of anything about the innovation. Paying critical attention to these qualities as presented by Rogers would be important in seeing implementation success of this EHR system. Additionally, Effective communication is vital in ensuring that nurses and other health professionals are aware of any procedure or product and how it will be used or impact upon their profession. To adequately inform nurses about the innovation, in this case, would require an appropriate media or cosmopolite sources.

References

Fickenscher, K., & Bakerman, M. (2011). Change management in health care IT. Physician executive, 37(2), 64-7.

Gruber, N., Darragh, J., Puccia, P., Kadric, S., & Bruce, S. (2010). Embracing change to improve performance: implementation of an electronic health record system. Long Term Living: For the Continuing Care Professional, 59, 28-31.

Green, L. W., Ottoson, J., Garcia, C., & Robert, H. (2009). Diffusion theory and knowledge dissemination, utilization, and integration in public health. Annual review of public health, 30, 151-174.

Hyrkäs, K., & Harvey, K. (2010). Leading innovation and change. Journal of nursing management, 18(1), 1-3.

Kaminski, J. (2011). Diffusion of innovation theory. Canadian Journal of Nursing Informatics, 6(2), 1-6.

McGonigle, D., & Mastrian, K. (2014). Nursing informatics and the foundation of knowledge. Jones & Bartlett Publishers.

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