Problem: Howard Davidoff, the President of Tri-State's Surbiton hospital, clicked on the Zoom icon and pulled his thoughts together. It had been a month since Carmen and the CEO had visited Surbiton to enroll the site as their model for a relaunch of the SmartScope tool. What they said made sense: for the tool to work, it had to be adopted and used consistently throughout the system. But for that to happen, it would work best to have a single hospital serve as a model of how SmartScope could be used.
Howard had eagerly agreed. Surbiton was geographically far from Tri-State's headquarters and as an older facility could use any investment or attention it got. Howard was a physician as well as an executive, and spent Thursdays working as a thoracic surgeon. He saw the point of any artificial intelligence tool that could help and had been an active driver of the SmartTool process. Part of this had involved setting up a network of change agents in major parts of the Surbiton site. They met weekly. Today, Howard had asked everyone to check on progress and report on support / resistance.
Howard's meeting started, and after a few minutes of small talk and welcome, he had Jodi from Accounting share updates from the SmartScope team on how frequently the tool was being used. Jodi paused at the end of the data rundown, and said "Well, kind of what the SmartScope people predicted has happened....lots of initial use, then a drop-off as people experience challenges, then a gradual increase on use. In our case, the uptake is a little better than in most places."
"Well," said Howard, "OK. But let's spend our time this morning looking at where people are, what they feel about SmartScope, and of course what we can do about any push-back we're seeing. Tammi, what is going on in the Medical Groups offices?"
Tammi looked at her notes anxiously. "Bit of a disappointment here. As you know, we have eight separate sites, two labs and six doctors' offices. All the site Managers got the training and everything else they needed and sounded pretty positive. No questions or issues, and reports indicated pretty good initial uptake and use of the tool. But, after a month, and despite no-one saying anything negative, it turns out that our physicians, with a few exceptions, are just using the tool when there's a really big question. As SmartScope says, it's most helpful when it's used frequently. But....despite our making that clear, it seems people don't want to do that." Heads nodded among the others on the call.
"Well....sounds like we're onto something. Moving on, John from HR....you have a not so quiet person to tell us about! "
John, the HR Director on Howard's staff, groaned and raised his hands in a "what are ya gonna do" gesture. "After my last visit from Dr. Mountjoy, I checked her files. She was never in the navy, but she can certainly swear as if she was. My Dad would have been impressed. In a sanitized nutshell, she feels the SmartScope tool is an insult to her brilliance, and that in fact she could help them improve it, being that she is one of the country's best pediatric cancer neurosurgeons. Or the best. She slammed her SmartScope on my desk as she left to go and complain to Howard. It still works, by the way!"
Howard nodded grimly. "At least she felt John listed to her. Me, not so much, as she said when she left my office! The point is she at least is saying what she doesn't like. And, well, could she be right? This is a lady who operates successfully on children with brain tumors several times a week. She is a superstar. How do we respond to that objection? How do we get more people to open up?"
Silence settled on the meeting....encourage resistance? Howard often surprised the group. "Now," he said, "any ideas from the work that you started with the staff in Obstetrics, Amy?"
Amy, a young and energetic doctor who managed the 13 staff physicians in Obstetrics, spoke next. "I don't get it.....we have a group of well-trained people who are tech savvy, but they just aren't seeing a lot of value so far from the tool. I am not sure how often they are using it. I have done it a lot, and it's confirming what I see, and occasionally making some useful suggestions. I try talking about this, and most people are seeing the same. I think the fact that the second opinion is needed seldom (so far anyway!) may make people feel this is a solution in search of a problem."
Howard nodded and took notes. "Are we that good? Or are we sort of seeing the tool the wrong way? Radiology....here and everywhere at Tri-State and in general, is still looking at the thing." He sighed. "Surah, what's going on?"
"Yes...here there's a real question about imaging assessment. As you know, for imaging-based diagnostics SmartScope has a function that is not on the hand-held. We have used a similar one for a while....the one from Mayo Clinic. Our team has set up a controlled study to compare the AI functionality and accuracy of the tools. This has been going on a long time. We pulled in a couple of research-based Interns, and the more we look at it, the more questions we find to look at and the more time it takes. It could be worth it, or....." Her voice trailed off.
"Hmmm. OK, I'm sure SmartScope has some figures on this, but, well. We are data-drive people, aren't we? OK. Finally, Jan, Nurse Practitioners, on the front-line of diagnosis."
"Total mixed bag....it's mainly Nurse Practitioners who turn to SmartScope....even RN's don't do a great deal of diagnosis that would require SmartScope. Most people love it and use it a lot. But, there is a feeling, mainly among nurses and assistants who don't use the tool, that SmartScope could take away from peoples' jobs, dumb them down. And despite how hard it is to hire nurses and how much growth the field's going through, there's still that nagging fear of job loss or 'being replaced by a machine' ."
OK," said Howard. "We have good news and bad news. I'm not sure what to do with the resistance we have here. What are you all seeing? What are the priorities, and what can we do about them?
What were the main approaches to communication seen here? How well did they work? What would you have done differently?