Updating tech or a process flow? Don’t forget to RHIP into your power structure.

If you’ve ever embarked on a process to update a piece of technology in a health system or, lets be honest - any company or organization, you know that there are countless books, certifications, specialties, Kaizens, Six-Sigma and LEAN Black Belts and other alphabet soups that are there to help.
Best advice, pick one, learn it and go with it as best you can.

One tool that many of these approaches may be lacking, based on research from Harvard School of Public Health’s Management Professor Michaela Kerrissey, is something affectionally called the “RHIP” framework (Risk, Habit, Identify, Power). Its purpose is to understand the unforeseen human elements that could scuttle any technology implementations or process change based on existing organizational power structures.

In short, you drafted a problem statement that your multi-stakeholder team agreed to, you built a consensus model approach to change, you defined and accomplished a set of goals that everyone aggressively agreed upon. Yet your technology implementation still failed because of “something else.”

That something else, may have been a lack of attention paid to the risks assessed through RHIP:

The impact of the RHIP framework was recently summarized using a case that Kerrissey wrote for Harvard in an NPR podcast by Planet Money. The case explores a failed effort to transition E.D. doctors away (in one of the most technologically advanced health systems in the world) from the decades-old technology of pagers to a new smart-phone-based approach.

Despite a text-book approach to planning and executing the intervention, the effort failed. An examination of the risks presented by RHIP factors, may have helped to illuminate why.