Surfing the healthcare bell curve

As a healthcare change management consultant, I’m interested not only on what changes to make but when. You see, as with so many things, changes in healthcare can often be represented by a bell curve. At first, the numbers of people or organisations making the change is low. These are the pioneers. They expend considerable resources to gain an initial advantage. Then the pace of change increases as more people observe the benefits and economies of scale make the change cheaper. There’s a peak at the top of the bell curve because the majority of people and organisations have made the change. After that, the pace of change declines – with only the very cautious finally coming on board, almost literally behind the curve.

For examples of changes conforming to a bell curve, think of general practice adopting online services, dentists offering tooth whitening and optometrists increasingly providing acute eye care services.

When to ring the changes?

Whether you are a dentist, surgeon or nurse, many changes will be imposed – by amendments in the law or regulations or resulting from a performance assessment or inspection. Other changes may come about through research and shared good practice. These are all changes you either cannot or should not resist.

Of interest here are entirely voluntary changes – adopting new procedures while the existing ones are working satisfactorily. Buying the latest piece of equipment before the old one has failed. Training staff in tasks they may need in the future.

Studies of Diffusion of Innovation Theory (as it is called) invariably have five categories of so-called adopters: Innovators, Early Adopters, Early Majority, Late Majority and Laggards. You can see their distribution on a bell curve here:

Note that these categories refer to consumers of products and services, so here comes the potential Catch 22 – if your adoption of a new healthcare service doesn’t coincide with take-up by patients you may have new equipment rarely required or staff not using newly acquired skills. Conversely, fail to jump on the bandwagon of patient adoption in a timely manner and you could lose business.

Predicting the future

If only! Any of us able to interpret the swirling mists in a crystal ball reliably would give up working and just win the Lottery each week. Meanwhile, how can we at least get some idea of likely developments in healthcare? The NHS Five Year Forward View gives clues – more digitisation, greater patient involvement and the adoption of healthcare technologies developed by the life sciences industry, for example. Case studies from the NHS Clinical Entrepreneur Programme and the NHS Innovator Accelerator programme can be insightful. Then there’s the work of think tanks such as The King’s Fund – a recent blog discusses better harnessing of the skills of allied health professions (AHPs). Don’t forget conferences as a way of gaining insights into future developments – for example, the Digital Health World Congress 2017 takes place in London on 29-30 November. Last year, speakers discussed (among other topics) the emerging roles of cloud computing, the internet of things (IOT) and artificial intelligence in healthcare. To find out about developments by life science companies in your field, the Government Office for Life Sciences has a useful company mapping tool here:

Change is the norm

Plus ça change, plus c'est la même chose, no longer applies in healthcare – if it ever did. As a change management consultant, I prefer the words of management guru and author, Peter F. Drucker: “Everybody has accepted by now that change is unavoidable. But that still implies that change is like death and taxes it should be postponed as long as possible and no change would be vastly preferable. But in a period of upheaval, such as the one we are living in, change is the norm."

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