The Influence Behind Successful Health IT Change

The most important voices in your project may not appear anywhere on your organizational chart. A charge nurse mentioning during shift change that the new system “actually makes sense” can shift adoption faster than any formal announcement. Meanwhile, the enthusiasm of an informatics nurse might carry less weight if colleagues see the role as disconnected from frontline realities. Influence in healthcare often comes from credibility and trust, not from titles or project assignments.

Recognizing where influence really lives

Formal authority and actual influence are rarely the same thing. In healthcare, peer credibility often outweighs official roles. Long-tenured staff hold weight regardless of job title, and frontline workers often turn to colleagues who “just get it” when technology changes.

These influencers are not always obvious. They might be the quiet staff member others seek out for clarification, the unit clerk nurses ask about technology, or the physician who checks with a trusted nurse before trying a new process. They may never attend IT workgroup meetings, and some only cover weekend or night shifts that leadership rarely sees. What sets them apart is that others rely on their perspective when deciding how to respond to change.

Engaging informal influencers

Informal influencers respond best to authentic engagement. They do not want a formal role or a long list of project tasks, and forcing those expectations often backfires. What works is respectful involvement:

🎯 Seek their input, but don’t assign responsibilities

📖 Provide clear, jargon-free information they can share

🩺 Acknowledge their expertise and how their colleagues rely on them

⏱️ Respect their time and independence

Just as important is knowing when not to push for more involvement. These relationships depend on transparency, reasonable expectations, and respect for competing priorities. Their influence is voluntary, which means trust is easier to maintain when engagement remains flexible and purposeful.

Helping them help others

The most effective way to work with informal influencers is to make sure they have clear, accurate, and practical information so they can respond to the questions and concerns their colleagues will likely bring forward. 

🔄 Give them early notice about upcoming changes so they can prepare

📝 Share straightforward explanations of why changes are happening

📂 Create quick-reference resources they can pass along

🚀 Respond quickly when they raise issues, and keep them updated on resolutions

This creates a healthy flow of information. They surface concerns from peers, you address them, and they in turn communicate updates back to their colleagues. It becomes a two-way channel that strengthens trust on both sides.

Sustaining the relationship

Informal influencers should be supported, not overused. Drawing on their credibility for every small initiative can lead to fatigue, while ignoring them between projects risks losing the relationship altogether. Respect their judgment about when to engage their networks, and give them space to decline when needed.

Transparency with formal leadership is also essential. Using informal influence ethically means ensuring that it complements, rather than undermines, official authority. Maintaining boundaries and respecting confidentiality preserves both credibility and trust.

How informal influence shapes adoption

Informal influencers can accelerate adoption or slow it to a crawl. By observing how teams naturally communicate, engaging these individuals with respect, and supporting their role as trusted resources, health IT leaders can strengthen change management strategies beyond what formal structures alone can achieve. These relationships, maintained over time, become long-term assets that extend far beyond a single project.

These dynamics become especially visible during large implementations, where informal credibility can influence how entire departments respond to change.

I saw this firsthand with an emergency physician during an EHR implementation. He wanted nothing to do with the new ED module and was convinced it would significantly disrupt workflows. Colleagues often went to him for technology advice, so his skepticism carried weight. 

Several members of the project team recognized that involving him early could be valuable. By asking for his perspective during design and testing discussions, we surfaced concerns that not not have appeared otherwise. He was later invited to user acceptance testing and encouraged to point out every bug, broken workflow, or usability issue he could find. 

By showing that we were open to feedback, and by addressing concerns where possible, we gradually built trust. Over time, he became more comfortable with the changes and eventually became one of the strongest advocates for the ED module during go-live.

Informal influence is rarely visible on a project plan, but it often shapes how teams respond to change long after formal meetings end. The people others trust for perspective, reassurance, or practical advice can influence adoption in ways that no communication strategy or leadership title can fully replicate.