Developing Leadership Skills for an EHR Transition
by Beth Hjort, RHIA, CHP
Thank you to Advance Magazine for permission to use this article

Convention speaker Leslie Ann Fox, MA, RHIA, encouraged her listeners to look inward and explore a new leadership style. In her session “Systems-based Leadership for Transition to the Electronic Health Record (EHR),” Fox, president and CEO of Care Communications, described the systems-based leadership approach as a way that HIM professionals can grow personally and help their organizations reach goals, such as EHR development. Fox emphasized that projecting leadership presence and defining the unique contributions HIM professionals bring to the transition is vital for those who wish to be a positive force behind EHR implementation.

She also tied current realities to historical lessons by recounting the contribution of economist John Kenneth Galbraith, who identified the mark of a leader: “All of the great leaders have had one characteristic in common; it was the willingness to confront unequivocally the major anxiety of their people in their time. This and not much else is the essence of leadership.”

Reaching the Tipping Point
Fox developed the systems-based leadership approach when she was inspired by Bowen family systems theory, which recognizes the effect of behavior on the success of a journey. Systems-based leadership requires gaining insight into our own patterns of behavior and understanding how they play out in a reciprocal relationship. During the interactive session, Fox asked her listeners to reflect on the anxieties of society as well as those of HIM professionals. She asked them to think about the importance of leadership, to reflect on challenges related to the EHR transition, and to set personal leadership development goals.

Fox urged the group to recognize that with the upcoming transition to the EHR, the healthcare industry is reaching the “tipping point” or moment when a concept becomes accepted by the masses. During this transition period, tension in healthcare organizations is likely to become more intense, requiring individuals who can recognize and manage their own workplace relationship anxiety. These individuals—especially those in positions of authority—will emerge as effective leaders in the system.

Understanding How We React
But it’s about more than managing anxiety, Fox said. Effective leadership means being able to gain mastery over our own emotional reactions in the midst of turmoil. How well we are able to do this depends on how we master what is called “differentiation of self.” This level of differentiation refers to the capacity to cope calmly and thoughtfully with external or internal stress and the resulting reactivity in a system. When an effort is made to increase personal differentiation, individuals can recognize options and makes choices based on their own beliefs. Systems-based leadership recognizes human groups as “emotional systems” with observable, predictable patterns of behavior. An individual’s behavior influences the behavior of every other member of the group—just like pulling on one piece of a mobile automatically shifts the position of every other piece. “When we are on ‘automatic pilot,’ we react instinctually to situations or the behavior of others rather than pausing to reflect and choose a response,” Fox said. By gaining insight into one’s own reactions and the human tendency to fall back into instinctual responses, one comes to recognize personal choice as critical toward becoming a highly differentiated individual, Fox said. These individuals can serve as a thoughtful, calm catalyst for change within a relationship system.

Seeing through a New Lens
How is this leadership concept different from traditional beliefs about leadership? By viewing organizational behavior through the “lens of emotional process,” leaders can learn to define themselves in ways more likely to reduce anxiety, Fox said. It starts with introspection and self-assessment—discovering and taking personal responsibility for our automatic and instinctual responses. As leaders work toward functioning at a higher level of differentiation, they become less reactive. Replacing reactive behavior with clear and thoughtful positions reduces anxiety in others. In other words, just as anxiety is contagious, being calm is contagious, too. There’s an added lifelong benefit, Fox said: this leadership process is not solely for the EHR challenge. It can bring new freedoms in any area of living—both personally and professionally. .

Journal of AHIMA/January 2004