Digital transformations: how to convince people to embrace change

November 21, 2023
Digital Health
Changes don't happen by chance. They are driven by organizational culture and leader that has the charisma to motivate people to leave their comfort zones. Good managers create the narrative of change based on shared vision and values. According to historian Yuval Noah Harari, every abstract form – whether it's money, progress, innovation, or religion – is a story. Through stories, the human brain can understand phenomena that are not physical. Stories stick and involve the entire brain. Managers use stories to justify the changes in an organization. For example, digital transformation in healthcare is often explained by classic storytelling about challenges: health workforce shortages, aging populations, and rising healthcare budgets with no better health outcomes. Doctors are promised that thanks to digitization, they will be relieved of administrative burdens and gain more time for the patient. Sound convincing? Not for everyone, since it is only the first element of change management – realizing the urgency of the change. According to change management guru John P. Kotter, this should be followed by specific actions: creating a change team, formulating a vision and an action plan, mobilizing people who support the change (enthusiasts), removing obstacles to implementing the change, focusing on achieving quick successes, maintaining the pace of change and consolidating the results of the change by embedding them in the organizational culture. Kotter's approach was created in 1955 and has since lost some relevance due to new social challenges. Following his approach, we take the steps forward only when the fear of the negative consequences of no change is greater than the fear of change.

Appreciative inquiry to prevent change fatigue  

We live in a time of constant change, leading to chronic change fatigue. We are overburdened with information about groundbreaking changes: climate change, the artificial intelligence revolution, wars, the COVID-19 pandemic, geopolitical changes, and economic crises. Unsurprisingly, when a manager announces a digital transformation strategy, the staff sighs deeply instead of the expected enthusiasm. Contemporary theories related to change management focus on two new aspects: reformulating the classical approach to the change process and removing the barriers that make the changes difficult. For example, instead of presenting a new narrative that everything must be changed because it is outdated, managers can show the situation from a different perspective – starting from what is working well and the fact that we want to keep doing it. Digitization? Yes, but let us first emphasize what we value in the current work model and want to keep it: close contact with the patient, relationships within the team, balance between online and on-site visits, etc. This kind of thinking gives the team a sense of continuity, of what they have worked hard on and what works well.
Four forces that hamper change are inertia, effort, emotion, and reactivity.
"If change lacks continuity, and if what is cherished, valuable, and proven is not preserved, people will resist it, regardless of the amount of pressure applied," according to Boris Nitzsche, communicator for social change and systemic coach. This approach is called "Appreciative Inquiry" and focuses on identifying and understanding what has been going well within an organization. It involves analyzing success factors and using them as a foundation for new solutions and change processes. "Appreciative Inquiry is not about ignoring problems and shouldn't be mixed up with "positive thinking." It instead emphasizes the importance of recognizing and preserving elements that have proven successful, align with the organization's self-image, or hold significant value for other reasons. The approach seeks to ensure change while maintaining continuity by building on existing strengths and positive aspects," claims Nitzsche.

Status quo vs. better future

 Managers too often focus on potential benefits. Less paperwork thanks to a new IT system? Automation of processes? Better access to patient data? Positive arguments sooner or later meet resistance from individuals and teams. Loran Nordgren and David Schonthal – authors of the book "The Human Element" – believe that every time a new idea is introduced, two opposing forces come into play: fuel (the appeal of the idea and how it is communicated) and friction (the brakes on innovation inherent in people). Most people are convinced that a great idea is all it takes for others to accept it quickly. Such a fuel-oriented approach is not enough when implementing organizational change. Nordgren and Schonthal give a simple example of a company that began selling a personalized, fashionable, high-quality, and comfortable sofa at an attractive price. The product was perfect; customers visited the website but did order it. Only thorough research explained what was wrong: the customers did not know what to do with their old sofa, essentially how to dispose of it. When people do not want to accept a new idea or a change, the problem lies in internal psychological obstacles – and one of them is our tendency to perceive reality negatively, a thinking pattern inherited in the evolutionary process. The fact that negative events are more intensely experienced than positive ones allowed our ancestors to survive. Rustling bushes triggered the instinct to flee because a tiger could hide there. Blood pressure and pulse rate would rise quickly, preparing the body for a fight. A beautiful flower does not trigger such emotional reactions since it potentially doesn't influence our chance of survival. Consider change as a bullet: your arguments and ideas are fuel for the shot. But air causes invisible resistance. This drag force can be broken down into four categories: inertia, effort, emotion, and reactivity. Inertia is the internal desire to maintain the status quo. People prefer what they already know. To remove this obstacle, you must introduce several alternatives rather than forcing employees to accept a single choice. Besides, every innovation should be implemented in small and predictable steps. Any change requires effort and energy. The objectively measured effort (training, new procedures, etc.) may differ significantly from the effort perceived individually. Cleaning an apartment may only take several dozen minutes, but sometimes, we think it is a colossal assignment we can't manage. The trick is to demonstrate that the amount of time and energy required to implement the idea is small while the benefits are disproportionately large. Emotions are the next inhibiting element. As mentioned earlier, they are a natural human trait. The leader's task is to explain the change empathetically, involve the team, and show that the change does not threaten anyone. On top of this, there is also what is called reactivity, or the impulse to resist change. We accept changes if they are ours, but we interpret those from others as a threat to our autonomy, a form of restriction of control. People must not feel forced to change; instead, they should perceive that they are the co-authors of the change. Whether a bullet reaches its target depends not only on the amount of gunpowder but also on the rules of aerodynamics.