Advertisement

Online Health Care: A Classic Clash of Technology, People, and Processes

  • John Butler
  • Dan Dalan
  • Brian McCourt
  • John Norris
  • Randall Stewart
Chapter
Part of the Health Informatics book series (HI)

Abstract

This statement, in an e-mail to all physicians at FutureCare Medical Group, epitomized the ambivalence many physicians had for On-Line Patient Services. “Me too,” a partner chimed-in. “WE’LL GO BROKE!” e-mailed another. And so, a string of e-mails expressed frustration, doubt, and even shear refusal to participate in this major strategic initiative. Encouraging patients to send e-messages to unenthusiastic doctors would be a recipe for failure. Without physician support, the project would go nowhere. What was happening? What should be done?

Based on a real life scenario with some fictionalized details, the organization, indivi­duals and email text presented in this paper have been altered to protect confidentiality.

Keywords

Transformational Leadership Role Conflict Online Service Complex Adaptive System Appreciative Inquiry 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Melzer SM, Poole SR. Reimbursement for telephone care. Pediatrics. 2002;109(2):290-293.CrossRefPubMedGoogle Scholar
  2. 2.
    Chin T. AMA delegates sort through patient e-mail issues. At: http://www.ama-assn.org/amednews/2000/07/10/tesb0710.htm. Accessed 12.05.08.
  3. 3.
    American Medical Association. Current Procedural Terminology CPT 2008 Standard Edition. Chicago: AMA; 2007.Google Scholar
  4. 4.
    Porter S. New, revised CPT codes target online, telephone services. At: http://www.aafp.org/online/en/home/publications/news/news-now/practice-management/20080229cptcodes.html. Accessed 12.05.08.
  5. 5.
    Robbins SP, Judge TA. Organizational Behavior. 12th ed. Upper Saddle River, New Jersey: Pearson Prentice Hall; 2007:640-658.Google Scholar
  6. 6.
    Kotter JP. Leading Change. Boston: Harvard Business School Press; 1996.Google Scholar
  7. 7.
    Robbins SP, Judge TA. Organizational Behavior. 12th ed. Upper Saddle River, New Jersey: Pearson Prentice Hall; 2007:378-416.Google Scholar
  8. 8.
    Gunderson L. Physician burnout. Ann Intern Med. 2001;135(2):145-148.Google Scholar
  9. 9.
    Hallowell EM. The human moment at work. Harv Bus Rev. 1999;77(suppl 1):58-64, 66.Google Scholar
  10. 10.
    Deladisma AM, Cohen M, Stevens A, et al. Do medical students respond empathetically to a virtual patient? Am J Surg. 2007;193(6):756-760.CrossRefPubMedGoogle Scholar
  11. 11.
    Poses R. More on physician reimbursement, CMS, the AMA’s RVS Update Committee (RUC) The healthcare blog. At: http://www.thehealthcareblog.com/the_health_care_blog/2008/05/more-on-physici.html. Accessed 12.05.08.
  12. 12.
    Robbins SP, Judge TA. Organizational Behavior. 12th ed. Upper Saddle River, New Jersey: Pearson Prentice Hall; 2007:75.Google Scholar
  13. 13.
    Breckler SJ. Empirical validation of affect, behavior, and cognition as distinct components of attitude. J Pers Soc Psychol. 1984;47(6):1191-1205.CrossRefPubMedGoogle Scholar
  14. 14.
    Ash J, Sittig DF, Campbell E, Guappone K, Dykstra R. An unintended consequence of CPOE implementation: shifts in power, control, and autonomy. AMIA Annu Symp Proc. 2006;11-15.Google Scholar
  15. 15.
    Landon B. Changes in career satisfaction among primary care and specialist physicians, 1997–2001. J Am Med Inform Assoc. 2003;289:442-449.Google Scholar
  16. 16.
    Reinertsen JL. Zen and the art of physician autonomy maintenance. Ann Intern med. 2003;138:992-995.PubMedGoogle Scholar
  17. 17.
    Williams ES, Konrad TR, Linzer M, et al. Refining the measurement of physician job satisfaction: results from the Physician Worklife Survey. Med Care. 1999;37(11):1140-1154.CrossRefPubMedGoogle Scholar
  18. 18.
    Lorenzi NM, Riley RT. Managing Technological Change: Organizational Aspects of Health Informatics. 2nd ed. New York: Springer; 2004:140-141.Google Scholar
  19. 19.
    Wikimedia Foundation. Change management (people). At: http://en.wikipedia.org/wiki/Change_management_%28people%29. Accessed 13.06.08.
  20. 20.
    Robbins SP, Judge TA. Organizational Behavior. 12th ed. Upper Saddle River, New Jersey: Pearson Prentice Hall; 2007:645-646.Google Scholar
  21. 21.
    Ackerman K. Report finds low EHR adoption rates. iHealthBeat. Oct. 16, 2006. At: http://www.ihealthbeat.org/articles/2006/10/12/Report-Finds-Low-EHR-Adoption-Rates.aspx?a=1 Accessed 13.06.08.
  22. 22.
    Wikimedia Foundation. Project management. At: http://en.wikipedia.org/wiki/Project_manage­ment June 13, 2008
  23. 23.
    Center for Medicaid & Medicate Services. At: http://www.cms.hhs.gov/physicianselfreferral/downloads/cms-ao-2008-01.pdf Accessed 13.06.08.
  24. 24.
    Markle Foundation. A common framework for personal health information. At: http://www.connectingforhealth.org/commonframework/docs/P9_NetworkedPHRs.pdf June 13, 2008.
  25. 25.
    Evans C, Marshall P, Derman J, Zeiger R. Platforms and personal health applications: what is the tipping point for interoperability? Panel presentation at: AMIA 2008 Spring Conference; 2008 May 29-31; Phoenix.Google Scholar
  26. 26.
    Jones T, Reti SR, Jenkins M, Bates DW, Zuckerman AE. Addressing the challenges of using PHR in the primary care setting, Panel presentation at: AMIA 2008 Spring Conference; 2008 May 29-31; Phoenix.Google Scholar
  27. 27.
    Kaiser Permanente. Kaiser permanente EHR system facts-KP HealthConnect electronic health record. At: http://www.kphealthconnectq4update.org. Accessed 13.06.08.
  28. 28.
    Robbins SP, Judge TA. Organizational Behavior. 12th ed. Upper Saddle River, New Jersey: Pearson Prentice Hall; 2007:517.Google Scholar
  29. 29.
    Ash JS, Stavri PZ, Kuperman GJ. A consensus statement on considerations for a successful CPOE implementation. J Am Med Inform Assoc. 2003;10(3):229-234.CrossRefPubMedGoogle Scholar
  30. 30.
    Lapointe L, Rivard S. Getting physicians to accept new information technology: insights from case studies. CMAJ. 2006;174(11):1573-1578.PubMedGoogle Scholar
  31. 31.
    Robbins SP, Judge TA. Organizational Behavior. 12th ed. Upper Saddle River, New Jersey: Pearson Prentice Hall; 2007:474.Google Scholar
  32. 32.
    Zimmerman B. Edgeware. Insights from Complexity Science for Health Care Leaders. Irving, Texas: VHA Publishers; 1998.Google Scholar
  33. 33.
    Plsek P, Greenhalgh T. The challenge of complexity in health care. BMJ. 2001;323:625-628.CrossRefPubMedGoogle Scholar
  34. 34.
    McDaniel RR, Jordan ME, Fleeman BF. Surprise, surprise, surprise! A complexity science view of the unexpected. Health Care Manage Rev. 2003;23(3):266-278.Google Scholar
  35. 35.
    Miller WI, McDaniel RR, Crabtree BF, Stange KC. Practice jazz: understanding variation in family practices using complexity science. J Fam Prac. 2001;50(10):872-878.Google Scholar
  36. 36.
    Stacy R. The science of complexity: an alternative perspective for strategic change processes. Strategic Management Journal. 1995;16(6):477-495.CrossRefGoogle Scholar
  37. 37.
    Lorenz E. The Essence of Chaos. Seattle WA: University of Washington Press; 1993.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • John Butler
    • 1
  • Dan Dalan
    • 1
  • Brian McCourt
    • 1
  • John Norris
    • 1
  • Randall Stewart
    • 1
  1. 1.Department of Medical Informatics & Clinical EpidemiologyOregon Health Science UniversityPortlandUSA

Personalised recommendations