The Threat of Technology

By: Patricia (Pat) Kroken, FACMPE, CRA, FRBMA
Originally Published in RBMA Bulletin July/August 2023

As a manager, it’s easy to fall in love with the promises of new technology.  The allure may involve improving processes and reducing costs, using technology to cut back on staffing (reducing costs) or generating a whole new level of life-changing analysis.  I’ve been in those presentations, bought off on the conclusions and excitedly anticipated the promised new world as we awaited implementation the new software package. 

And here we are on the edge of artificial intelligence (AI) offering viable technology options, being told how it is revolutionizing the workplace, replacing people and yes, reducing costs.  What could possibly go wrong?

Nobody on the sales team prepares you for how difficult it is to accomplish tech’s big changes, especially if the staff is entrenched, comfortable and competent with the old way of doing things.  Think about how you embrace (or hate) the latest Microsoft changes to applications you frequently use, or how you react to the introduction of a new multi-factor authentication process or what happens when you forget to update your password and can no longer access the computer system.  Aggravating?  Yes and now we’re going to launch change in every aspect of your job.  Excited?

The background of our challenge

Artificial intelligence has been in the news for several years, along with the prediction it will replace a wide range of jobs traditionally done by humans.  We have watched with interest, perhaps excitement and depending on the job, with a sense of foreboding.  If you’ve been in a software presentation and watching the reaction of staff members, their faces reflect the revelation of “but that’s my job” or they’re doing the math, trying to figure out how many positions will be eliminated and calculating the likelihood they will survive the cuts.  Even in the best scenario, you are introducing uncertainty, anxiety and for some, a career-ending event.  Now let’s get pumped up about the conversion!

How will you communicate with staff, both to prepare them for adapting to changes in their work and in terms of explaining how technology will impact staffing levels?  In some cases a current job description will go away but a different position is created so it’s critical to thoroughly understand each step in the before-and-after workflow.  And how will “the old way” be transitioned?  For example, when implementing new billing software there is an early decision regarding whether to separately work down the old accounts receivable or move all data to the new system.  Here’s a key question: “Is there any crappy information in the old system?”  The answer is always “yes” (just ask your staff) so why not start fresh in the new system without transferring duplicated information and errors?  To do this most efficiently, it means a portion of the staff may be needed for the old A/R and depending on the size and complexity of the practice, it could take up to a year to clear that information.  This means staff reductions (usually a key selling point) will not occur immediately and normal attrition can begin to address the issue.     

The more answers you can develop and communicate, the less threatening change will be to staff members.  In fact, ongoing and clear communication is essential in successfully managing change and will minimize the impact of inherent disruptions.

The thing nobody tells you

The following example is in reference to changing billing systems but provides a warning for other technological changes as well.  It is not unusual for a number of employees to resist the change—to the degree they will try to prove it won’t work.  Does this mean they will attempt to sabotage the transition?  Yes.  They may not develop a specific plot but will consistently experience problems beyond the normal learning curve and complain “it doesn’t work.”

You might expect this behavior from older employees who are considered less computer savvy; however, it’s worth noting there isn’t necessarily an age implied with resistance and boomers can quickly embrace a new way of working.  Instead, it often involves those who have carved out an expertise niche in the old system, who can be more threatened by having to start over at an equal level with everyone else, losing their position in the department as a “go to” for problems and questions.  Do the saboteurs ever win?  On very rare occasions they can prevail but usually there are also other factors at play when that happens.  They are more likely to cause operational problems in the transition, extending the time it takes to complete the conversion and eventually leaving a mess for others to clean up.

The staff member of the future

As AI addresses certain production-focused tasks formerly completed by a human, the human moves into an oversight position of auditing, clearing up inevitable problems and “oops” errors (bound to occur in the array of inconsistent healthcare policies) and identifying further process steps that could be automated.  The demands on the staff of the future will require the development of additional skills, a deeper understanding of processes and the ability to quickly identify and correct errors.  This also implies a deep understanding of the software in use, including its limitations. 

Life will be difficult for the department “one trick pony,” who has resisted change and remained in one job slot for decades.  It will be easier for those who mastered tasks in a number of positions over the years, who became de facto experts in multiple processes and who helped others solve problems. 

The successful staff member of the future will utilize emotional intelligence to communicate, teach and encourage others.  She will also demonstrate efficient problem-solving skills, be able to analyze potentially complex situations and be receptive to further automation as it makes sense.  There will be fewer people required to do the same amount of work and normal attrition will help thin the herd, especially for those unwilling or unable to transition to a more complex and demanding world.

Preparing for change

The unknown is stressful and implies anxiety.  When people don’t know what is going on, or why, they will begin to fear the worst and creatively fill in the blanks.  Their fear becomes contagious in the office, consumes the oxygen of productivity and permeates the culture.  What can you do?

  1. Explain the project to staff in the larger context of challenges the group is facing and why change is needed. To the extent possible, involve staff members in vendor meetings and the selection process. 

  2. Involve staff members in documenting the “before” workflow, especially where there are hand-offs to another process step.

  3. If a particular process is automated, how does that change any human involvement before, during and after that step?

  4. Based on practice variables, where are problems most likely to occur? This could include how the group acquires data and whether multiple hospital computer systems are involved.  You may find you have been dealing with an outlier that will not fit into the new plans for some reason (often their system limitations) and a different set of decisions regarding how to accommodate them.  

  5. Communicate as clearly as possible how AI will be implemented and what it is intended to do. Will it be phased in gradually and each site/process tested before widespread implementation or is the goal to change across the entire system at once?

  6. What are some opportunities for staff members? Again, the trend with many technological advancements is for certain jobs to shift to auditing roles rather than the person continuing to perform the job functions.  What does the auditor need to know?
     
  7. Will some “before” areas need to be concluded by part of the staff as new processes are introduced at a designated cut-off point?

This is by no means a comprehensive list but it can get conversations started. 

While announcing change always implies the threat that upheaval will follow, it is better to communicate and involve staff as much and early as possible.  The threat of change will still be there, but it may not set off a stampede of disruption.  After all your best people are also the most employable so you need to keep them on the team.

Patricia Kroken, MSN Healthcare Solutions Director of Education and Corporate Communications

FACMPE, CRA, FRBMA

Prior to joining MSN Healthcare Solutions as Director of Education and Corporate Communications, Pat Kroken had nearly 30 years of experience in radiology management as both a practice manager and consultant to radiology groups, billing companies, software vendors and hospital radiology departments.

Pat has had more than 200 articles published, is a regular contributor to the Radiology Business Management Association (RBMA) Bulletin and a frequent speaker on practice management topics. She served two terms as President of the RBMA, is Editorial Advisor for the national RBMA publication, The Bulletin, and represented the “business side of radiology” as RBMA Liaison to the Radiological Society of North America (RSNA) Associated Sciences Consortium for 7 years. 

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