The Doctor is In: Playing the Right Role

Dr. Robert Cuyler

In this continuing series on telemedicine implementation, I have highlighted both the key success factors and the common fault lines of project launches.  In the last post, Preventing Telemedicine Underachievers, my focus was on the role of senior leadership in shaping and communicating the vision for telemedicine.

So let’s assume first that the boss has delivered a series of strong and unambiguous messages that telemedicine is a key ingredient in the organization’s future.  So what happens next?

In our book Implementing Telemedicine, Dr. Dutch Holland and I use the metaphor of the theatre as an organizing principle for telemedicine implementation.   Today, we have come to the section where we discuss “roles.”

Imagine a theatre director who decides to transition the company from ‘Streetcar Named Desire’ (an organization pre-telemedicine) to ‘Last of the Red Hot Lovers’ (after telemedicine is implemented). How ridiculous would it be if the star actor from the first play wanted to use his best lines in the new play because they worked so well before? (Stella!! Stella!!!!) What a terrible idea!

Surprisingly, in organizational change projects, we all too often find that old roles are not fully examined, revised and transformed for the new play. Even if the new role retains some elements of the old  (for example, personnel who are involved in a blend of traditional and telemedicine care), each player must have real clarity about the new work processes involved, which may involve new scheduling, medical record management, and diagnostic/treatment protocols.

Let’s take this metaphor a bit farther. Would a theatre company ever stage a play without multiple dress rehearsals?  Not on your life! Does it happen in organizational technology initiatives? All of the time.

Here’s a memorable example. A rural health center rolled out its new telepsychiatry program, linking urban doctors with their distant location.  For the doctor, the 8 a.m. start meant just that – and the video call dialed on schedule.  On the clinic side, 8 a.m. was time to open the doors, brew the coffee, and pull the day’s charts, with patients trickling in over the next hour. Was the doctor happy that day? Was the doctor confident that this new telemedicine method was the wave of the future? I don’t think so.

Today’s take away:  Don’t raise the curtain on your new telemedicine program before all the actors are in place, with all of their lines and cues well rehearsed.

Note: Dr. Robert Cuyler and Dr. Dutch Holland will be hosting a discussion and book signing for Implementing Telemedicine at the LifeSize booth (#142) at ATA 2013 on Monday, May 6 at 4 p.m.

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