Introducing Technology

In the last decade technology has influenced healthcare and EMS. For organizations that have not yet transitioned to a more technology-rich environment, the decision to move in that direction can appear to be daunting. The staff's reactions to technology are likely to span the spectrum from complete acceptance to defiant rejection. These reactions can influence the organization's "success" of accepting the technology and it may even have system-wide influences. Consider the following example.

EMS system "X" has used paper-based charting for decades. Over the past year system X has been exploring the potential of transitioning to an electronic patient care system. A small project team was created and numerous meetings have occurred. The project team obtains information from 6 vendors that offer mobile electronic patient care document systems.

While the project team reviews the proposals and conducts due diligence, the EMS crews learn about this project through their shift meetings and message boards. Several staff members have expressed their concerns about the potential of using a mobile device. Comments such as "...great, another thing I have to carry...." and "...I can hardly type as it is...and now they want us to do this in the field", are voiced.

During "B" shift one unit has a mobile device that they are testing in the field. This unit is located in a high call volume area and has not been overly supportive of the idea of going "paperless". During the shift the unit runs a lot of back-to-back calls. When this unit was using the paper charting they were able to be back in service very quickly. Today's shift is the complete opposite. The crew is not having a successful day using the mobile device and they are falling behind on their documentation. In addition, the printing system for the mobile unit keeps having problems.

Before the shift ends the EMS crew calls their supervisor, explains the situation, and informs them that they are going back to paper for the duration of the shift. The supervisor understands and helps the crew get back in service.

During the shift change the EMS crew shares their frustration using the mobile system with anyone that will listen. Other crews hear about the details and start dreading using the handheld when they are rotated to that unit. As the conversations continue the resistance against using the handheld increases. The supervisor arrives at the station and begins to hear the conversations and soon realizes that the crews are not happy. The supervisor realizes that the management team and staff will need to get together to discuss this so that they can overcome this hurdle.

What to do in a situation like this? While EMS system "X" could benefit from the technology, it is going to be helpful to have buy-in from the staff. The above situation, which is based on a true event, will not be solved in a few minutes. It will require input from a variety of people as well as additional planning. The event described above was eventually resolved. Several key lessons-learned and opportunities were identified. The following highlights some of the findings.

Management buy-in
The management team of the organization supported and believed in the idea of using the handheld device. This originally was not the case and had to be addressed. Comments similar to "Here we go again. We tried this 3 years ago and the project lasted all of 2 weeks. When is senior management going to get with it?" When managers, regardless of their rank/role/title, do not support the project or product, it can easily undermine the project. This can also trickle throughout and organization and lead to resistance.