I got an email from Atlassian today that contained a link to a white paper on digital transformation entitled “Unblurring the lines of a digital transformation: Knowing what something is not is as important as knowing what it is”. It’s a bit of an infomercial, but it made three points, the first of which really hit home with me, because I have run into it so often.
“Bringing in new technology to simplify and speed up work, or just moving to the cloud is not a digital transformation. Ask yourself, what are you transforming? You might be optimizing your current practice, but your methodologies have not changed.”
Far too many times, I have seen technology adoption with the expectation that it is going to be layered atop the current manual practices and somehow make magic happen. As a good friend of my once said, layering technology over a broken manual system just makes it break faster!
I understand why we gravitate toward that notion. Change is hard. Once we have done something the same way a few thousand times, we reach unconscious competence (at least for that way of doing things) and it becomes second nature. We come to equate habit with competence.
There are actually four stages of learning:
1) Unconscious Incompetence – we don’t know what it is we don’t know and may not believe we need to know it.
2) Conscious Incompetence – we know what it is we need to know but do not yet know it. We have become aware of our need to learn.
3) Conscious Competence – we have developed the skill necessary to perform a task or role, but only succeed at it with conscious attention to the task; it takes effort to be competent.
4) Unconscious Competence – we no longer need to think about applying the skill, it just comes naturally.
Our progress through these stages can be painful, but, in the end, it seems worth it. How many of us remember what it was like to drive a car for the first time? I was clearly unconsciously incompetent and scared my parents to death!
Once we have reached unconscious competence, moving backward is psychologically painful. We feel incompetent. So, we “tweak” automated systems so that they feel like our old manual way of doing things rather than embracing change that might actually take us to unimaginable benefits.
I grew up in the age of the rotary dial telephone. We had telephone books that had local phone numbers in them. If we wanted to call another city or state (heaven forbid, another country), we had to involve an operator. If we needed a telephone number we couldn’t find in our phone book, we had to call an information operator. Had the industry not moved us past that to button-dialed phones with digital connectivity, we would not have any of the tools we take for granted today. The link takes you to a video of a description of how, in 1958, industry made a conscious decision to change the way telephony works. Had that not happened, it is hard to imagine how we would have the connectivity we have today. Yet, I clearly remember the wailing and moaning when we moved from a 7-digit to a 10-digit telephone number.
Yet, if we are going to truly transform our practice (as opposed to just tweaking it at the edges), we must somehow learn to embrace that change. So digital transformation is not just about having the latest toys or more software. It is about using technology to approach our practice in new ways, to stop doing things we used to do, and to start doing new things that truly transform our practice.
So, it is as much about culture as it is about the technology. I have been privileged in my years in industry to know professional colleagues who have built a culture that embraces and manages change considering what is known about human psychology; cultures that enjoyed change. I learned so much from them about planning for change, managing its pace, celebrating the early wins, and expecting some of the early failures.
If you could change anything about how your practice today, what would it be? What technology might make that feasible. What changes would such technology make in the way you spend your day?
What do you think?
As always, the comments in this blog reflect my thoughts and not necessarily those of ASHP or of my employer.
Dennis A. Tribble, PharmD, FASHP
Ormond Beach, FL
datdoc@aol.com