It’s Time for a Change…Again

Clinical Researcher—September 2019 (Volume 33, Issue 8)


Paula Smailes, DNP, RN, MSN, CCRP, CCRC


We all see it. Technology moves fast, at what seems like lightning speed.

I bought my daughter a Chromebook last July for school and the salesperson said it would likely be good for a year, two years maximum. Suddenly, the expense of this item doesn’t seem like a good investment, despite the educational value. Recently, my old, faithful work laptop died. My new laptop has all the latest features that the old one didn’t, and I haven’t a clue how to work most of them or the time to learn.

Whether it’s a necessity or not, the urge for having the latest technology is a driving motivator for consumers in the 21st century. So much so that the current 2019 predictions for consumer spending on technology is estimated to reach $1.32 trillion.{1}

Technology Upgrade

Technology turnover to the latest system version is big business. This may not occur because new features are appealing; it may be needed to help information systems perform both optimally and efficiently. System updates may be inclusive of new software that protects the system from hackers, malware, and viruses.

From a business perspective, organizational leaders must also consider the likely effects of new technology on the financial bottom line. Within those considerations, one may include a risk/benefit analysis of upgrading vs. not doing so, along with what the potential return on investment may be of that action.

Unintended Results


As technology is turning over, so are the piles of waste growing. It has been noted that the rise in electronic consumption has two significant adverse ecological impacts:

  1. It creates a substantial increase in mining and procurement of materials needed for production and gadgets.
  2. Discarded devices produce large quantities of electronic waste.{2}

This issue has become of such importance that the U.S. Environmental Protection Agency supports the government’s National Strategy for Electronics Stewardship in an effort to manage electronics throughout the lifecycle of these products.{3}  Ten years ago, it was estimated that 438 million electronic products were sold in the United States, and 2.4 million tons were ready for end-of-life management.{4} These numbers have rapidly increased each year due to consumer demand.

Change Fatigue

Beyond the material impact, there can be a psychological impact from constant change, especially in terms of technology. Change fatigue is a phenomenon that impacts each person differently, with past and current experiences contributing to its severity. It manifests in a variety of ways, such as low energy or lack of enthusiasm for change. Employees may feel unfocused or overwhelmed, and they may lose motivation due to a lack of buy-in or readiness for a pending innovation. As employees become disengaged, the impact on business operations can be an unintended consequence.

Researcher Impact

As someone who is responsible for ensuring that clinical researchers know how to use an electronic medical record (EMR), I can attest that keeping them updated on system changes is not an easy task. Whenever we change the system, I can guarantee we will change it yet again in the near future. This commonly happens just as end-users are settling into their new workflows with the system. Therefore, don’t get comfortable!

At our organization thus far in 2019, the EMR system alone has had three major changes in six months that have impacted clinical researchers. When I teach classes, I tell those in attendance that when I teach the class again in a few months, the section on EMRs will be different.

Obviously, technology change for clinical research is not limited to EMRs. Clinical trials management systems, electronic case report forms, medical equipment, and much more all inevitably change. Whatever the system, the goal in our industry is succeeding in times of change.

Strategies for Success

The old saying goes, “Those who fail to plan, plan to fail.” Since change is inevitable with technology, it’s even more important to have adaptive strategies for success that do not impede the workforce when change happens. Here are a few considerations:

  • Downtime: Change may occur and users won’t have access to the new system right away. Is there a back-up plan in place? How will staff continue their work?
  • Training: When technology change occurs, what is the training plan to make users successful?
  • Communication: Give plenty of advanced notice to make sure people have time to mentally adjust to the idea of change. Additional communication is necessary on what the change will be and when it will come.
  • Time: While you may feel like you don’t have time to learn about the changes, it’s important to educate yourself on what they are and how to operate new software or hardware.
  • Ripple Effect: Some specific staff members are expected to be impacted by change, but who else will be affected? Have a customer service approach allowing that delays may occur as system transitions are made, and consider what service recovery can be done in cases of serious delays.

From an organizational leadership perspective, consider how much change is too much. Frequent change without time to adjust can lead to stress, anxiety, turnover, burnout, and other negative outcomes. Be mindful of when staff may be reaching their saturation point. Consideration for reducing the discomfort of change includes the frequency and nature of change, along with the level of supportive leadership provided to employees.{5}

Employees should also be empowered to speak up when it all becomes too much. As technology change becomes a way of life, we need to proactively consider the necessity and impact of this inevitable process.


  1. IDC. 2019. New IDC spending guide forecasts consumer spending on technology to reach $1.3 trillion in 2019, led by communication and entertainment use cases.
  2. Ahmed. 2016. The global cost of electronic waste.
  3. U.S. Environmental Protection Agency.
  4. U.S. Environmental Protection Agency.
  5. EAD. 2015. Change fatigue in health care professions—an issue of workload or human factors engineering?

Paula Smailes, DNP, RN, MSN, CCRP, CCRC, ( is a Visiting Professor at Chamberlain College of Nursing and Senior Systems Consultant at The Ohio State University Wexner Medical Center.