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  Today in Health it, this story is culture more than technology will determine our pace of innovation in healthcare. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week in Health IT at channel dedicated to keeping health IT staff current and engaged. This week in health, it now includes feature stories.

You can check them out on this week, health.com. All right. Here's today's story. I wanted to do something that was a little less controversial and something that's interesting and I'm using as source for this, A Washington Post story, and it is titled an app that swiftly sends CPR Volunteers to Heart Attack Sufferers has made a big difference in Denmark.

Could this be copied in the us? And I'm gonna give you some excerpts from this. Denmark has seen a dramatic increase in survival from heart attacks. After it began recruiting volunteers and arming some of them with smartphone technology that alerts them to nearby cardiac emergencies and helps 'em locate AEDs.

The volunteers are then asked to enter residences and perform CPR until an ambulance arrives in Denmark. The smartphone Heart Runner Community first responder app allows dispatchers from the National Health Emergency number 1 1 2 nationwide to contact up to 20 volunteers within a 1.1 mile radius from the scene of a cardiac arrest, the dispatcher will alert the ambulance services.

May guide the person who called in to commence CPR until the volunteers arrive. Can you run the app asks and volunteers respond? Yes. Are either first directed to the address shown on the screen or to the nearest a ED, and then to the scene of the more than a hundred thousand registered Danish volunteers.

He said Eisenberg, the resuscitation pioneer, who has been developing CPR techniques and teaching them for more than 30 years said the Danish experience suggests the huge potential this technology. Would have in the United States. You can do the math. If a neighbor can get to a scene and start CPR within three to five minutes of a collapse, there's a reasonable chance of successful resuscitation.

He said, if nothing is done for 10 minutes, it's a very low probability of success in Denmark civilians. Respond faster than professionals to more than four in 10 cardiac arrests out of hospitals. Data from the Danish Cardiac Arrest Registry Show how this all works was clear on a recent Sunday evening when the fast response of neighbors activated by the Heart Runner app probably saved Eric Harry Cax, KAXE 81, when his heart stopped beating in his home on the outskirts of hesta, a small town in Western Denmark.

Within minutes, 10. Strangers living nearby had arrived to his rescue well before the ambulance arrived. 17 minutes after the call, Lene Courtguard, a social and healthcare assistant, and her husband, a truck driver, had just finished dinner when the loud alarm sounded from their Heart Runner app. As they drove to C'S address shown on their app screen, an emergency service operator was dispatching the ambulance and guiding C'S wife to perform CPR.

Several other volunteers notified by the app arrived along with the quarter guards. Carrying multiple AEDs. Quarter guards performed CPR. She said, while another volunteer prepared the defibrillator with plenty of volunteers available, it was a hectic atmosphere. Quarter Guard said, but it meant they could do more than just CPR having responded to similar calls in the past, she was comfortable to lead the small army of volunteers.

And directed some to wait by the main road to guide the ambulance to the house. Others cleared furniture to make room for the stretcher and help C's, distressed wife call their daughter. They also helped move Mopes the dog out of the way to the bathroom with a bowl of water as well. When the ambulance arrived, CAX was breathing, he survived the ordeal and is now

Has increased from four to 16% in the past 20 years in the United States, before the pandemic hit, the survival rate stood at 9.8%. There are several similar apps in the US, but concerns about safety and willingness of people to accept untrained volunteers into private homes have prevented a similar wide use of PulsePoint, a North American responder app.

But if those concerns are overcome, the United States could significantly improve its survival rate. Leading experts say. There is no reason why we should not pursue this said Professor of Medicine, Thomas Ray, who studies pre-Hospital emergency care at the University of Washington. Alright, so that's the case study of what we're gonna talk about today and what we're gonna talk about is culture.

More than technology will determine our pace of innovation. This has really always been the case. It's been the case with every kind of technology project that I can think of. Change management is the cornerstone to successfully implementing technology in support of whatever we're trying to do. You have to win people's hearts and minds.

You have to align with the will of the power brokers, and you have to clearly demonstrate trust, competence, and value. The reason I talk about power brokers is because power brokers have the ability to kill a project, and we've all seen this. They can do it directly. They can just stand up and use their bully pulpit to say why this project won't succeed and why they can't support it.

And why it is not in the best interest of the, the health system or the patient or whatever they're going to say. They can also rally the troops. They can rally a group of people around them and create a larger group that is influencing the culture against it. They can marshal others to their aid, either professional organizations or regulators and lawmakers.

There are a lot of ways to do this. The language is usually very polished and professional and communicated as in the best interest of the patient or the community or humanity. The arguments are almost always too hard to argue against. They end up being crafted by professionals and really speak to the heart of whatever the mission is, whatever the core mission is.

So you have to win the power brokers. I remember early on in my stint as a CIO. I was looking for a quick win. I was looking for a project where we could really make a difference in the lives of the clinicians, and we had a project called EZPass, and EZPass was a single sign-on solution that allowed the clinicians to move from station to station.

Badge in Badge out. And we had gotten this login process down to, uh, sub One Minute for the first time login and for multiple roaming logins. It was literally seconds, and the desktop was right back to where they were working from. And there were some that were against that, but what we ended up doing was.

Building momentum. Small win after small win amongst certain groups of physicians. We had physicians who were champions who created videos for us, and we went out there with those videos in hand and we eventually rolled that out across the entire organization. And that's how you have to win them over one at a time.

You have to help them understand what's in it for them. How does it work for them? People have to want it. This is why we build on quick wins and also a burning platform. If we don't do this, people will die. Now, that wasn't the case with EZPass, but it is the case with this solution that we're talking about here.

That is a perfect burning platform. If we don't do this, if we don't figure out a way to get to the cardiac patients outside of the hospital faster than whatever the timeframe is before the ambulance gets there, people will actually die. That is a burning platform. Quick wins, demonstrate the trust, competence and value, and make each subsequent move easier to scale.

You either need large wins or a lot of wins very quickly. Digital transformation will be limited by the power brokers and our ability to win the hearts and minds of the general public or whoever the project is being rolled out to. Whoever builds a successful transformation project based on the patient alone will have truly accomplished something.

I can't even come up with a single one that has done that, to be honest with you. If, if you can build it based on a groundswell of patients saying, look, we want this. Because the patients have not been empowered in healthcare and they really don't have the money. They pay through insurance, they pay through providers.

And so the people with the money are the insurance carriers and the providers and other entities within the the healthcare ecosystem. And so the patients themselves are unwilling to pay for anything directly. So it's really hard to get that groundswell if you're just going after the patient. As I look at this heart app.

That Denmark is using. It took 20 years to really change the culture, to get people to be open to this process, to get it integrated into the normal flow of business. And in the United States, we still don't have a propensity to do this project, even though the technology's already there. And that gets back to the main point, which is you have to be able to initiate cultural change.

There has to be an adoption of the story, the story that you're telling, saving lives through this process. We have the same exact technology in the United States that they have in Denmark, but we haven't been able to sell the story. That's number one. Number two, there are power brokers that are standing in the way of this, that are saying, look, let's just wait until the ambulance gets there.

We know based on the data that we now have from Denmark, that there is a case to be made for this to be successful in the United States. But it requires us to get through the power brokers to say, look, this is not encroaching on your space. This is something that is gonna augment your ability to support the community and to save lives in your community, and therefore it is something that we want to try in our community.

And then you build off of those quick wins and you build more trust. You build more competence, you get better at the process itself, and that is how you begin to build momentum on a technology project. That is how you change the culture and create the adoption that you want for the technology project.

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