CHALLENGE 04
Treating Workflow and Adoption as Post-Sale Problems
A Health IT company can win the contract, complete the implementation, and still fail to create the outcome the provider expected.
The reason is that successful deployment is not the same as successful adoption.
If a solution changes how clinicians, staff, or operational teams work, then workflow fit, behavior change, training, ownership, and adoption are not simply implementation issues to address after the sale.
They are part of the buying decision.
Providers are evaluating whether the technology can work inside the organization—but also whether the organization can realistically work differently because of it.
Implementation puts the technology into the organization. Adoption is what turns the technology into value.
Seller’s Lens vs. Buyer’s Lens
Health IT companies naturally focus on whether the technology can be implemented successfully. Providers are also evaluating what implementation will require from the people expected to use it every day.
SELLER'S LENS
“We can implement this.”
The seller sees:
- successful technical deployment;
- integration with existing systems;
- configured workflows;
- completed training;
- user access established;
- implementation milestones achieved;
- product functionality available;
- and a completed go-live.
From the seller’s perspective, successful implementation means the solution is operational.
BUYER'S LENS
“Will our people actually use this the way it needs to be used?”
The provider is asking:
- How will this change existing workflows?
- Who will have to work differently?
- Does the solution add or remove steps?
- How much training will be required?
- Who will support users after go-live?
- What happens if adoption is inconsistent?
- How will we know whether workflows are actually improving?
- Who owns adoption if the technology is technically working but users are not engaging?
A solution can be technically implemented and still fail operationally.
Why This Becomes a GTM Problem
When workflow and adoption are treated as post-sale responsibilities, the vendor may win the contract without fully understanding whether the provider can achieve the value used to justify the purchase.
The Demo Works Better Than the Workflow
The product performs well in a controlled demonstration but creates friction inside real clinical or operational processes.
Training Becomes the Adoption Plan
The organization assumes that teaching users how the product works will automatically change how they work.
Users Develop Workarounds
Staff find ways around the technology because it does not fit naturally into existing routines.
Usage Looks Acceptable, but Value Is Missing
People may log in or complete required steps without changing the outcome the business case depended on.
The Vendor Goes Quiet After Go-Live
Implementation is considered complete, but no one is actively evaluating whether users are adopting the intended workflow.
Expansion Stalls
Leadership is reluctant to scale because adoption at the initial location remains uneven or difficult to measure.
The sale may close before the organization has answered whether people will actually change the way they work.
Provider Perspective
Hiyam Nadel
Massachusetts General Hospital
Design With the People Who Will Use It
Olga Maciejewski
University Health Network
Change Management Begins Before Go-Live
Marisa Farabaugh
AdventHealth
Local Adoption Must Precede Enterprise Scale
Hiyam Nadel
Director, Center for Innovations in Care Delivery, Massachusetts General Hospital
Design With the People Who Will Use It
Frontline clinicians and operational teams understand workflow in ways that technology vendors—and sometimes even leadership—cannot see from a conference room.
They know where friction exists, what steps are essential, which workarounds have developed, and what additional burden a new technology may create.
Bringing those users into the conversation early helps determine whether the solution fits the actual environment rather than an assumed version of it.
The GTM implication
Do not wait until implementation to discover whether the people expected to use the technology believe it fits their workflow.
Olga Maciejewski
Change Management Lead, University Health Network
Change Management Begins Before Go-Live
Technology adoption is rarely just a training exercise.
People need to understand why a change is happening, how it affects their role, what is expected of them, and where they can go when the new process creates friction.
That means change management needs to begin before deployment—not after adoption begins to struggle.
A technically successful implementation can still fail if the organization has not prepared people for the change.
The GTM implication
If the solution requires behavior change, the commercial conversation should include change readiness before the contract is signed.
Marisa Farabaugh
Chief Supply Chain Officer, AdventHealth
Local Adoption Must Precede Enterprise Scale
A solution that works in one location may not automatically fit the workflows, leadership structures, or operating environments of other facilities.
Before expanding across a large health system, the organization needs confidence that adoption can be reproduced—not simply that the technology can be installed again.
The GTM implication
Scale depends on repeatable adoption, not just repeatable implementation
How to Diagnose Workflow and Adoption Readiness
Map the Workflow Before You Sell the Workflow Change
Before proposing improvement, understand how the work is performed today.
That includes:
- who performs each step;
- what systems are involved;
- where handoffs occur;
- what workarounds exist;
- where delays or friction appear;
- which steps users consider essential;
- and what would have to change if the solution were adopted.
Without that understanding, a vendor can unintentionally introduce new friction while solving another problem.
Workflow fit cannot be determined from the product demo alone.
Identify Who Must Change Behavior
Not every implementation requires meaningful behavior change.
But when it does, the sales team should understand exactly who will have to work differently.
That may include:
- physicians;
- nurses;
- schedulers;
- revenue-cycle staff;
- analysts;
- IT teams;
- operational leaders;
- or administrative staff.
The larger and more diverse the affected group, the more important adoption becomes to commercial readiness.
The more people who must change behavior, the less adoption can be treated as an implementation detail.
Define Adoption Beyond Logins
Usage does not necessarily equal adoption.
A user may log into a platform because it is required.
A clinician may complete a new step without believing it improves care.
A department may technically use the tool while continuing old workflows around it.
The provider and vendor should define what successful adoption actually looks like.
That might include:
- percentage of eligible users using the intended workflow;
- frequency of appropriate use;
- reduction in manual workarounds;
- completion of specific workflow steps;
- time saved;
- improved throughput;
- or measurable clinical or operational outcomes.
Adoption should be measured by whether the intended behavior and outcome are occurring—not simply by whether the software is being accessed.
Establish Ownership After Go-Live
One of the most important questions is:
Who owns adoption after implementation ends?
Someone needs responsibility for:
- monitoring use;
- identifying friction;
- collecting feedback;
- reinforcing the workflow;
- addressing training gaps;
- escalating problems;
- and determining whether the expected value is being realized.
If ownership ends when the project team declares go-live complete, adoption risk increases substantially.
Go-live is an implementation milestone. It is not the end of the adoption process.
Diagnostic Content — Bottom Line
Workflow and adoption readiness means understanding not only whether the technology can be deployed, but whether the people, processes, ownership, and measurement needed to make it valuable are actually in place.
Better Discovery Questions — Don’t Ask / Ask Instead
Good workflow discovery goes beyond asking whether users will need training. It explores how the solution will affect the way people work and what the organization must do to make that change successful.
DON’T ASK
“Will your users need training?”
ASK INSTEAD
“What will users have to do differently once this solution is implemented?”
DON'T ASK
“Does this integrate with your workflow?”
ASK INSTEAD
“Can you walk us through the current workflow and show where this solution would change the process?”
DON'T ASK
“How will you measure adoption?”
ASK INSTEAD
“What behaviors or outcomes would demonstrate that users are adopting the intended workflow—not simply accessing the technology?”
The objective is not simply to understand whether the technology can fit the workflow. It is to understand whether the organization can successfully change the workflow.
From Implementation to Commercial Readiness
Before treating implementation feasibility as evidence of commercial readiness, the sales team should understand how the solution will affect workflow, who must change behavior, how adoption will be supported, and how success will be measured. The Buyer’s-Lens Test helps distinguish technical readiness from organizational readiness.
1. Questions Health IT Companies Should Be Able to Answer
☐ What workflow does the solution affect?
☐ Who performs that workflow today?
☐ What will those users need to do differently?
☐ Where could the new process create friction?
☐ Were frontline users involved in evaluating the workflow?
☐ What training or support will be required?
☐ Who owns adoption after go-live?
☐ How will adoption be measured?
☐ What behaviors demonstrate meaningful use?
☐ How will workflow problems be identified and corrected?
☐ What happens if adoption is slower than expected?
☐ Can the adoption model be repeated across additional departments or facilities?
If the sales team can explain how the technology will be implemented but cannot explain how users will adopt it, the value proposition remains at risk.
The Buyer’s-Lens Test
A workflow-ready opportunity should allow the provider to answer “yes” to each of the following:
✓ Yes, we understand how the workflow will change.
The organization knows what the solution will require from the people using it.
✓ Yes, the affected users have been involved.
Frontline perspectives have informed the evaluation and implementation plan.
✓ Yes, someone owns adoption.
Responsibility continues beyond training and go-live.
✓ Yes, we know what successful adoption looks like.
The organization has defined measurable behaviors and outcomes.
✓ Yes, we have a plan if adoption stalls.
There is a process for identifying friction, correcting problems, and reinforcing the intended workflow.
When those five answers are present, the provider is not simply preparing to install technology. It is preparing the organization to use it successfully.
David's GTM Takeaway
Health IT companies often treat workflow and adoption as implementation responsibilities.
That is too late.
If the value proposition depends on clinicians, staff, or operational teams working differently, then workflow fit and adoption risk are already part of the sales conversation.
The provider needs confidence not only that the technology works—but that its people can realistically incorporate it into the way care or operations are delivered.
Implementation puts the technology into the organization. Adoption is what turns the technology into value.