As IT consultants to the healthcare industry, we are often told that the technology solutions we implement must promote healthcare provider adoption, and that the vendor will be measured on adoption rates, sometimes resulting in penalties and non-payment. This is always a tough issue to deal with, especially first thing in the morning as I had to do recently.

The consulting industry has given the impression that you can address user-adoption issues by purchasing more of its services: extensive software “usability” initiatives or other high-touch efforts such as “change management” services. While it's true that these services can be essential in maintaining pre-determined adoption, it won't make users buy or use the system if they don't want to.

Have you ever bought something that you didn't really want to by the time you got it home? If you did, you probably didn't do it that often. And for those times that you did, you probably walked away feeling bitter with the company that sold it to you. This example can apply equally to vendors who are promoting technology solutions to healthcare providers.

The success of adoption is determined upfront through a well-defined strategy. A provider adoption strategy usually starts off by identifying what I like to call “carrots and sticks”. More specifically, you will need to identify what the provider will gain by using the recommended system and what are the consequences of not using it.

Next, you need to identify the strategic adoption levers that are already in place and can be re-used for a new solution. These levers often include incentives or other benefits, and should also align (include system usage alignment) with existing provider accountability agreements.

Once you and your client have the strategic levers identified, try to find the right balance of “carrots and sticks” that will bring about successful provider adoption and address the following key questions:

  • What's in it for me?
  • What's in it for my patients?
  • My clinical methods work well for me – why should I change?
  • If I do comply, who has my back when things go wrong? Who do I look to for support?
  • What are the implications of non-compliance?
  • Why should I care about using this system, who's going to know?

This is the perfect time to test the adoption rate before you build anything. It's what most large consumer companies do. That's right: “build it and they will come” is much riskier than “see if they will come and then build-it”. It's as simple as presenting the solution in a paper format or a mock-up. You should include the value proposition, adoption levers and answers to the key questions noted previously. This can be done in a representative survey or presented as part of a clinical working group. Remember to measure the willingness to adopt the proposed solution. The result is your adoption baseline.

Again, as IT consultants or change management specialists, we can only hope to maintain the pre-determined adoption baseline throughout implementation. If your client wants better adoption rates, re-visit the adoption levers and advise them how they might affect these levers for improved adoption. In most cases the vendor does not control these levers or is not a signatory to the provider accountability agreements and therefore cannot realistically “create” provider adoption by implementing technology solutions alone.