The rapid introduction of artificial intelligence (AI) has shifted the goalposts for technology implementations. While legacy systems have focused on optimizing and standardizing workflows, AI fundamentally rewrites them.
When technology profoundly alters daily operations, organizations cannot afford a weak change management strategy.
“Until now, much of the focus has been on helping people transition information from paper into structured digital systems,” notes Michelle Gallitto, SVP, Strategic Operations & Delivery, Excell Healthcare Advisors. “Now, people are being asked to allow machines to do some of the thinking—a change that demands a whole new level of trust.”
“AI is redesigning how work is done,” adds Michelle Heckman, SVP, Transformation & Execution, Excell Healthcare Advisors. “It’s about working with AI agents as collaborators to augment and accelerate decision-making.”
“…technology rarely fails on its own. Change management, clinician trust, workflow integration and organizational readiness are often the difference between a tool that transforms care and one that collects dust.”1
—Becker’s Hospital Review
As seasoned change management experts who advise executive and operations teams on transformation, Heckman and Gallitto have seen firsthand the difference between successful technology implementations and those that fail. Failures often have little to do with the software itself. The difference lies in an organizations’ ability to build bridges between the technology and the people who use it. More specifically, organizations must recognize opportunities to leverage AI within their workflows before they will achieve ROI.
In the following interview, Heckman and Gallitto discuss the hidden complexities of modern IT implementations, the human barriers to IT and AI adoption, and the proven change management strategies executives need to break through the inertia, improve buy-in, and safeguard their investments.
Question: Why is AI more disruptive to healthcare organizations than legacy IT implementations?
Excell Healthcare Advisors: With AI, humans are harnessing technology in entirely new ways, allowing us to shift from reactive to proactive as we make decisions faster. So, ultimately, AI implementations demand a deeper level of user trust. You are asking a human to trust a machine to supplement their thought process and tee up critical decisions. This introduces ethical considerations, biases, and widespread fears about job security that weren’t prevalent in the past. Because trust in AI-enabled systems is still developing, tolerance for AI mistakes is often lower than with more familiar tools or processes. Even small errors can quickly reduce confidence and cause people to revert to old workflows.
Question: We often hear that technology is 20% of the implementation effort, while 80% is people and processes. Does that still hold?
Excell Healthcare Advisors: Absolutely. In fact, AI only magnifies the people and process elements because it requires a deeper trust in the orchestration of workflows. You cannot optimize care management (CM), utilization management (UM), or any other technology without considering the people who use it. A new tool can be flawlessly deployed, but if staff members are not adequately supported through new ways of working, the implementation will fail. Change management now is aimed at building organizational resilience to handle continuous, high-speed advances, ensuring people understand the vision and are prepared to adapt without burning out.
AI introduces an added “trust tax.”
Change management must now build organizational resilience to handle continuous, high-speed advances, ensuring people understand the vision and are prepared to adapt without burning out.
Question: What are some of the hidden complexities that commonly sink a health IT implementation?
Excell Healthcare Advisors: Poor data quality and fragmented data are common technological hurdles. However, the most insidious “hidden” complexities usually revolve around workflow misalignment and a lack of clear governance. Frequently, new technology is designed for a workflow that doesn’t match what happens in reality. Or, it merely automates a broken manual process. Furthermore, because technology systems often impact multiple departments, it can lead to internal battles over who “owns” the system. Is it IT? Business operations? Clinical teams? Successful IT adoption relies on shared governance and ownership across all teams, including compliance, security, clinical, and business operations.
Question: How do these complexities differ when the technology involves AI and agentic AI workflows?
Excell Healthcare Advisors: Much remains the same, but AI introduces an added “trust tax.” As mentioned earlier, AI and agentic AI implementations necessitate a whole new level of trust in machines as collaborators that can augment human decision-making. Therefore, fostering user confidence and buy-in may be even more complex than the technological integration.
Question: Do these complexities differ when you are working with health plans versus provider organizations?
Excell Healthcare Advisors: No. The specific operational focus fluctuates, but the fundamental change management principles remain universal. Health plans typically manage complexities around claims, UM, CM, predictive analytics, and regulatory compliance. Provider organizations concentrate more heavily on clinical workflows, physician adoption, and clinical decision support. However, the human barriers—fear of change, the need to build trust, and the reluctance to abandon ingrained habits—transcend organizations. Meaningful change management support begins with understanding that each person navigates change differently; that reality holds true regardless of the type of organization they’re in.
Question: You mentioned employee fear, particularly regarding AI replacing jobs. How should leadership address this?
Excell Healthcare Advisors: Before introducing AI, leaders should articulate a clear people philosophy that defines how employees will be supported, developed, and impacted as work changes. This includes clarity on whether efficiency gains will result in upskilling opportunities or if headcount will be reduced through natural attrition. Aligning on that philosophy as a leadership team can take time and often entails tough conversations. However, this up-front investment will pave the way for lasting gains. Without transparency, employees may hesitate to fully engage because they are uncertain about the implications for their roles.
Question: Why is it easier for an outside expert to drive effective change management than an internal team?
Excell Healthcare Advisors: Internal teams are deeply embedded in their own processes. They’re often bogged down by historical silos, internal politics, and “the way we’ve always done it”—not to mention day-to-day operational fires. It’s difficult to reimagine work when you are too close to it. An external team brings objectivity. We can challenge ingrained assumptions and bring the benefits of having seen multiple successful—and unsuccessful—approaches across the industry. We can act as guides to sequence and facilitate an effective flow of conversations and break an organization’s inertia so it can finally move past the status quo.
Question: If a health leader were to start an IT implementation today, what is the single most important first step?
Excell Healthcare Advisors: Start with your operating model and goals, not the technology. Leaders must be crystal clear about their organization’s “true north”—its mission, values, and strategic goals—and know exactly what challenges they want technology to solve before they deploy it. Organizations that fail to establish this strategic context and unified philosophy, and instead treat AI like a shiny new object, often struggle with avoidable friction throughout the transformation as decisions become inconsistent and implicit assumptions surface.
Question: What other best practices ensure sustained adoption and minimize disruption?
Excell Healthcare Advisors: First, make sure communication is multi-threaded, frequent, and integrated into existing channels so the initiative feels like “how we work now” rather than a standalone project. Second, start with high-impact, low-risk pilots—like patient health summaries —to build IT and AI literacy and trust across the organization. Finally, tie success to simplifying work; show how the technology is a win for staff members. The true promise of AI is to remove repetitive administrative tasks so seasoned professionals, like nurses, never have to perform low-value tasks again and can instead focus on members and patients.
Question: How should healthcare organizations measure the impact of AI and other technologies?
Excell Healthcare Advisors: Understanding the impact of an AI implementation starts with having clarity on the problems you are trying to solve and defining specific measures of success. If AI is deployed to manage administrative burdens, an organization might measure an increase in capacity—for example, a nurse comfortably managing 16 cases a day instead of 12. Human Resources must be a key partner in this process, as individual roles, structural capacity, expectations, and definitions of employee success will fundamentally change as a result of the implementation.
Building for Resilience
Health IT implementation is not just a matter of shepherding “projects”; it’s about leveraging technology for true organizational transformation. The next few years may well be a period of great optimization. The organizations that thrive will be those that view IT and AI not as standalone solutions, but as enablers of a more agile workforce.
As predictive technologies and AI continue to evolve at breakneck speed, health plans and provider organizations will need to rely less on the novelty of technologies themselves and more on the resilience and adaptability of their people. Intentional change management strategies can help organizations embrace a culture of continuous transformation. By prioritizing strategic alignment, fostering deep trust, and leveraging experienced change management guidance, healthcare leaders can ensure their IT investments don’t just “launch,” but truly transform care management and delivery.
References:
- King, S. (2026). Why digital health initiatives fail: 35 healthcare leaders weigh in. Becker’s Hospital Review: 30 April. https://www.beckershospitalreview.com/hit-speaker-series-q-a/why-digital-health-initiatives-fail-35-healthcare-leaders-weigh-in/?origin=BHRSUN&utm_source=BHRSUN&utm_medium=email&utm_content=newsletter&oly_enc_id=6844C1894812I1A