Law Students

Big problems require small solutions. It's not that the end state solution will turn out to be small or trivial, in fact it is likely to be quite encompassing, but rather that the ultimate solution can only be achieved through a series of smaller solutions. In Switch, a book on change when change is hard (read HITECH), Chip and Dan Heath posit three core components of change:

1. the Rider (our rational side);
2. the Elephant (our emotional side); and
   
3. the Path (the context in which the change takes place).
   

All three must be aligned if change, within any difficult context, has any chance of succeeding. The authors summarize their findings as follows:

For things to change, somebody somewhere has to start acting differently. Maybe it's you, maybe it's your team. Picture the person (or people). Each has an emotional Elephant side and a rational Rider side. You've got to reach both. And you've also got to clear the way for them to succeed.

There is very little chance of success if the change agent appeals solely to an individual?s (or a group?s collective) Rider. No matter how compelling intellectually, or how strong the numbers look, appealing to the Rider alone is not sufficient to get the Elephant (our emotions) to move. In order for difficult change to occur we need to move the Elephant. Elephants don?t move easily, and when they do, they tend to go wherever they please.

Unless you move your organization?s Elephant you may likely implement one of several HITECH compliance strategies that is guaranteed to fail. Moving the healthcare Elephant is no small feat?yet another reason that the problem is wicked.  Fear of fines from Big Brother may be a necessary enough incentive for the Rider, but will likely prove woefully insufficient for the Elephant. You have to get the Elephant to want to move, because elephants don?t scare easily.

How do we get the healthcare Elephant to move? Commit to the patient. The patient wants his or her PHI secured. The patient wants you to ensure privacy. The patient wants anywhere / anytime electronic access to his or her PHI. Patients will soon start demanding from the healthcare industry what other industries provide as a matter of course (e.g. the banking industry), and they will get it. Innovative players within a highly competitive marketplace will find a way to deliver on the promise. To the victors go the spoils.

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