Inside Healthcare Innovation

Why Change Management Makes or Breaks Enterprise Transformation

One of the toughest lessons I learned early in my career came while helping an oncology clinic transition from paper records to its first electronic health record system. Even though the change was necessary, it was met with confusion, hesitation and resistance—an experience that showed me how critical thoughtful change management is to successful transformation.

Over time, as I’ve led and observed digital transformation efforts across payer and pharma organizations, I’ve seen this same pattern repeat itself. The more innovative the transformation, the more resistance it can face—particularly in healthcare, where inherent risk aversion often shapes decision-making. When change management is treated as a secondary consideration, even the most promising initiatives can struggle with organizational resistance and stalled adoption.

Recently, this lesson was reinforced through my Leading Change in Health IT course as part of my DrPH in Health Informatics at Johns Hopkins. Even with years of experience, revisiting Kotter’s framework was a valuable reminder that these fundamentals still matter—especially as AI solutions and enterprise-level transformations proliferate across healthcare and beyond. The technology is rarely the bottleneck; organizational readiness almost always is.

However, when we’re deep in the weeds or excited about the future a transformation promises, it’s easy to forget the importance of change management. Consider this a friendly reminder for those of us working in the innovation space to pause, ground ourselves, and revisit just how critical change management is to turning innovation into lasting impact.

Below is Kotter’s framework, applied through the lens of what I’ve learned across my professional journey.

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1. Stagnation Isn’t Neutral—It’s a Competitive Disadvantage

(Kotter’s Step: Create a Sense of Urgency)

Your organization is overwhelmed with competing priorities. Without clear, compelling urgency, your digital initiative becomes just another ‘nice to have’ that gets deprioritized. The solution isn’t to create artificial urgency—it’s to make the real urgency visible.

What You Can Do as a Leader:

• Present competitive intelligence showing how rivals are gaining market share with digital tools
• Connect to existential business imperatives—regulatory mandates, revenue pressures, quality metrics
• Share data on the status quo: inefficiency metrics, error rates, patient satisfaction gaps

2. Find Your Innovation Champions

(Kotter’s Step: Build a Guiding Coalition)

A C-suite leader I worked with used to tell my innovation team, “go where the love is,” when we were looking for allies to help socialize our strategy. That advice has stayed with me throughout my career. Digital transformation needs champions who have both influence and passion for innovation. Look for the people who naturally embrace new approaches, who others respect and turn to for guidance. These are your true allies—the medical directors excited about AI’s potential, the commercial leader eager to launch innovative products, the operations leaders who see efficiency opportunities.

Build your coalition with people who bring energy, influence, and cross-functional perspective. When these champions speak, their teams listen. When they advocate, adoption follows.

What You Can Do as a Leader:

• Identify informal influencers who combine innovation mindset with organizational credibility
• Build a cross-functional coalition spanning clinical, operational, IT, quality, and finance with real decision-making power
• Empower champions to shape the solution and evangelize across their networks

3. Paint What Good Looks Like

(Kotter’s Step: Form a Strategic Vision)

‘We need to be more innovative’ or ‘we need to do more omni-channel’ means nothing. The vision that drives change is concrete, emotional, and tied to mission. In pharma: ‘Enable precision medicine so every patient gets the right drug the first time.’ In health plans: ‘Give members answers in minutes, not weeks.’ These visions connect technology to purpose.

What You Can Do as a Leader:

• Focus on outcomes and impact, not technology features—make it about patients and mission
• Make it memorable—something people can repeat in 30 seconds
• Appeal to both head and heart: show the business case while connecting to professional purpose

4. Tell Stories, Not Slide Decks

(Kotter’s Step: Communicate the Vision)

A vision announced once at a town hall dies by Tuesday. The leaders who succeed communicate relentlessly through every channel—but more importantly, they communicate through stories, not only numbers and facts. Instead of saying ‘We’re implementing AI to improve efficiency,’ tell the story of the patient who got faster, more accurate care because of predictive analytics.

Stories make the vision tangible. They bypass resistance and create emotional connection in a way numbers alone can’t. And when leaders reinforce those stories through their own decisions and behaviors—consistently modeling the change they’re asking for—the message becomes far more powerful and far harder to ignore.

What You Can Do as a Leader:

• Use every communication channel repeatedly—but frame the vision through real stories of impact, not abstract concepts
• Share specific examples: ‘Here’s how Dr. Smith used the new AI tool to catch a diagnosis three other physicians missed’
• Walk the talk—make visible decisions that align with the vision, because actions communicate louder than words

5. Clear the Path Forward

(Kotter’s Step: Empower Action by Removing Barriers)

Most ‘resistance’ is actually barriers. People want to adopt new approaches but face real obstacles: outdated systems that don’t integrate, performance metrics that reward old behaviors, some teams who feel threatened change, misaligned incentives, or simply lack of training. Identifying and systematically removing these barriers is essential.

What You Can Do as a Leader:

• Ask frontline staff: ‘What’s preventing you from doing this?’ Then help fix those obstacles
• Align systems and structures: update performance metrics, modify workflows, provide adequate training
• Address resistant leaders directly—one senior leader blocking change can derail the entire effort

6. Plan for Quick Wins—Then Celebrate Them

(Kotter’s Step: Generate Short-Term Wins)

Transformation takes years, but momentum dies without visible progress. The key is deliberately planning for wins within 12-18 months—not hoping they happen, but actively designing achievable wins. Then publicly recognize and reward the people who made them happen. These wins prove the skeptics wrong and build credibility for bigger changes ahead.

What You Can Do as a Leader:

• Select initial pilots with high visibility and reasonable probability of success
• Define clear, measurable success criteria upfront—time savings, error reduction, cost savings
• Publicly celebrate wins and reward the teams involved—use success to build momentum

7. Don’t Lose the Momentum

(Kotter’s Step: Build on the Change)

After early wins, the temptation is to declare the transformation complete. Instead, use the credibility from short-term wins to tackle bigger, more entrenched problems. Expand to more departments. Take on systems that weren’t politically feasible before. Promote change champions. Keep the momentum going—real cultural change takes 5-10 years.

What You Can Do as a Leader:

• Use early wins as launching pads for bigger initiatives, not finishing lines
• Promote people who embody the new approach—send clear signals about what behaviors get rewarded
• Launch new projects that deepen the transformation before the first wave is fully complete

8. Make Innovation a Part of the Culture

(Kotter’s Step: Anchor New Approaches in Culture)

Change sticks when it becomes culture. This requires explicitly connecting the new approaches to improved performance, updating hiring and promotion criteria to reflect new values, and ensuring leadership succession plans prioritize change champions. Without cultural anchoring, everything reverts when attention shifts.

What You Can Do as a Leader:

• Explicitly show how new behaviors improved results—make the connection clear and visible
• Update onboarding, training, job descriptions, and promotion criteria to embed the new approach
• Ensure leadership succession plans prioritize people who champion the transformation

The Reality Check

AI transformation is one of the most talked-about topics in healthcare today, with genuinely transformative technologies now available for enterprise use. But getting hundreds of people to actually change how they work? That takes structured change management. Every transformation failure I’ve witnessed had great intent and poor change management.

In the age of AI transformation, 70% of organizations fail at transformation efforts. The 30% who succeed don’t have better technology. They have better change management.

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What’s been your biggest change management lesson in digital transformation? I’d love to hear your experiences in the comments.

References

1. Eastburn J, Fowkes J, Kellner K. Digital transformation: Health systems’ investment priorities. McKinsey & Company. https://www.mckinsey.com/industries/healthcare/our-insights/digital-transformation-health-systems-investment-priorities. Published June 7, 2024. Accessed December 10, 2025.

2. Finnell JT, Dixon BE. Clinical Informatics Study Guide: Text and Review. Springer Nature; 2022:436-450.

3. Kotter J. Leading change: Why transformation efforts fail. Harv Bus Rev. https://hbr.org/1995/05/leading-change-why-transformation-efforts-fail-2. Published May 1, 1995. Accessed November 11, 2025.