If you’ve ever been part of a system implementation in a fertility clinic, EMR, lab system, billing, patient app, you name it, you already know this truth:

Change doesn’t just happen in timelines and Gantt charts. It happens in people.

And people, especially in IVF clinics, go through emotional phases that are as predictable as stimulation protocols. Different personalities, same journey.

Over the past years implementing systems across nurses, embryologists, coordinators, reception, finance, and leadership teams, we’ve seen the same five phases over and over again, give or take a few dramatic sighs and passive-aggressive spreadsheets.

Phase 1: Curiosity

This is the honeymoon period. The demo looked shiny. The buttons looked friendly. The workflows looked cleaner than your current 87-step Excel workaround that only Karen knows how to maintain. People are cautiously optimistic.

Nurses ask if this will finally stop the constant back-and-forth about medication schedules. Embryologists wonder if they can ditch the paper logs from 2014. Admin secretly hopes to retire the colour-coded sticky notes that currently run the clinic.

Everyone is smiling, but in a “this could be great, unless it ruins my life” kind of way.

You will know you’re in this phase when someone on your team says: “This actually looks really good… but does it work on the days we’re busy?”

Phase 2: Confusion

Welcome to the valley of implementation. Old habits are strong. The new system is unfamiliar. Buttons have moved, workflows have changed, and your muscle memory is actively fighting you.

Nurses forget where to chart oocyte numbers. Embryologists click into the wrong cycle three times in a row. Finance asks why a button is “just slightly to the left of where it should logically be.” Admin tries to filter appointments and filters out the entire clinic instead.

Everyone is slightly annoyed. Some are VERY annoyed. And all of them are wondering whether they actually gave you the correct data during migration.

But this phase is not failure, it’s biology. Brains hate change before they love it.

You will know you’re in this phase when someone says:

“I swear I clicked the exact same thing yesterday and it did something totally different.”

Phase 3: Resistance

The nostalgia phase. The psychological equivalent of remembering your ex as charming even though they stole your charger, snored, and left dirty plates everywhere. Suddenly people start defending the old system. “The old EMR wasn’t that slow.” (Yes it was.) “Our spreadsheets worked perfectly.” (They didn’t. Also: no.) “I don’t see why we needed to change.” (You do. Deep down. You really do.)

This is where the real leadership work kicks in. If no one guides the team through this dip, coaches them, answers questions, sets expectations, laughs with them instead of at them, people get stuck here.

Every clinic that abandons momentum abandons it in Phase 3. Every clinic that pushes through becomes unstoppable.

You will know you’re in this phase when someone says: “Honestly… the old EMR wasn’t THAT slow.” (You and I both know it was.)

Phase 4: Acceptance

This phase lands quietly. People stop resisting and start… doing. Not enthusiastically. But consistently. Nurses begin to trust the medication instructions. Embryologists start entering data faster than they expected. Admin checks patients in without calling for help. Finance presses “send invoice” without sweating.

They might still roll their eyes publicly, but privately they’re no longer opening the old system “just to check something.” They’re building new habits. And habits create confidence.

You will know you’re in this phase when someone says: “Don’t tell anyone… but it actually wasn’t that hard today.”

Phase 5: Ownership

And then… it happens. The same nurse who once declared she would “never ever ever trust this system” is now correcting colleagues on how to do things “properly.” The embryologist who resisted everything in training is suddenly asking if they can get early access to phase 2 features. The admin team is organising their entire day inside the new system like they’ve been doing it for a decade. Finance is asking for more automation because “now that we see what’s possible…”

And the clinic collectively realises: “Wait. This is actually so much better. Where has this been all my life?”

People forget how hard phase 2 and 3 felt. They forget the frustration. They forget the spreadsheets they once protected like national secrets.

That’s the moment you know a transformation has truly landed.

You will know you’re in this phase when someone says: “Who changed this setting? Change it back. We finally had it perfect.”

Why these phases matter

The phases are universal, but the outcome is not. Fertility clinics that recognize and support these emotional stages move through them quickly, confidently, and with humour. Clinics that ignore them get stuck and call the system “the problem” even though the real problem was never the software.

In our implementation team, we expect these phases. We design around them. We plan for them and we show up for them. Sometimes, we even love them, because when teams reach phase 5, something magic happens.

They stop talking about wawa as “the new system” and start talking about wawa as their system. That’s the transformation.