The digital transformation challenge is cultural, not technical

FEATURE - Industry Innovation Article - Brian Biggs, director of customer relations and sales, New Zealand, InterSystems

All large-scale healthcare technology implementations involve significant change, with the right technology providing the potential to improve patient outcomes, optimise clinician workflows and secure cost savings.

But it’s not simply about installing hardware and software. It requires a cultural and, ultimately, human change. The impact on practitioners is particularly pronounced with large transformation projects, like those supporting New Zealand’s healthcare sector reforms.

Care improvement requires trust and collaboration among clinicians and their organisations. And that requires stakeholders to work in partnership to achieve common goals.

Digital transformation is not a ‘technical’ change
There is often a lack of acknowledgement that digital transformation is an ‘adaptive’ not a ‘technical’ change. This leads to the belief that digital transformation projects mainly involve hardware and software implementation. However, this is far from the whole truth. As a result, many organisations struggle to understand why digital projects run over budget, run late or outright fail.

What’s the difference? Technical changes lend themselves to quick and easy solutions, are usually solved by pre-existing expertise, and are often perceived as an extension of the past. They typically fit in with existing paradigms and can be implemented with existing skills and knowledge.

An example is replacing an old MRI machine. A new MRI machine will have some new functions requiring training. But the basic safety principles, use cases and user interface will have much in common. Most healthcare professionals will be familiar with the process and have a well-trodden change pathway involving little anxiety.

Adaptive changes are less clear-cut, more difficult to identify, easier to disagree with, and typically take more time. There are no precedents because adaptive changes lie outside existing paradigms. They necessitate a change in values, beliefs, roles, relationships and approaches to work. They also require new skills, knowledge and more resources. And understandably, some clinicians fear the impact of adaptive change and emotionally resist it.

Because digital transformation is an adaptive change, it takes more than investing in the latest software solutions to succeed. It also requires a holistic investment in the people and culture underpinning the sector and strong leadership.

Once the need for adaptive change is acknowledged, healthcare providers can benefit from the following five observations based on InterSystems’ global experience.

Don’t try to change the product
While healthcare leaders need to be flexible and open-minded when driving change, they must ensure that their organisations understand, respect and show loyalty to the chosen solution. Successful healthcare providers work with the product rather than trying to change it.

Healthcare leaders need to derive maximum value from the product and its supplier. Suppliers bring first-hand experience and expertise that touch many areas, but providers are likely to run into challenges if they try to make the product or supplier fit around their existing organisational setup rather than evolving and adapting to work with the new technology.

Research suggests that product choice predicts only 20% of user satisfaction. Other factors, such as training quality, are as, if not more, influential in predicting user satisfaction.

Acknowledge individual impacts
Implementing a healthcare information solution is in the interest of the patient and the care provider. For the individual doctor or nurse, however, it may mean changing how they operate.

For example, one of the benefits of an EMR system is to ‘surface’ data that was previously ‘buried’. This has many use cases for patient management, patient safety, quality improvement, strategic planning and population management, to name a few. However, data first needs to be captured, and often the expectation is that carers will be entering it.

A common complaint from clinicians is being taken away from directly caring for patients to enter and view patient information. Acknowledging and minimising this burden on frontline staff at the outset of a digitisation project is essential in planning and managing staff expectations.

Consult with doctors
Implementing a healthcare information system involves a significant change management project – usually driven by managers and senior hospital leaders. Because the medical profession is perceived as being change resistant, they are often not consulted. This can leave them feeling overlooked or even deceived when they are later told about the proposed implementation.

Digitisation leads and teams must understand this to manage the change process successfully. Doctors are arguably some of the most intelligent and motivated staff members, but they can be a potent resistor of change. Equally, with their support, digitisation projects in healthcare are far more likely to succeed.

Invest in strong leadership
Successful change programmes usually have strong senior-level leadership at the medical director and board levels. While often focused (or distracted) by operational delivery and pressing performance indicators such as patient waiting times, senior management also need digital project visibility. The importance of support from the medical profession makes medical director and CEO sponsorship critical to success.

Ensure a continuous partnership
All too often, technology providers operate in isolation from their customers. In the past, some IT vendors have implemented a system and disappeared, not helping the customer understand, grow, or develop the system. That often leaves the customer with unanswered questions and concerns. Instead, vendors need to continuously work with the customer to ensure the system works well, functionality is grown, and there are increasing levels of adoption.

Innovation and change in healthcare are urgently required to improve patient outcomes, optimise clinician workflows, and secure cost savings. But this need brings about a corresponding requirement for adaptive change management and a well thought-out and implemented strategy to support it.

And, while technology is an integral part of digital transformation, choosing a solution is at least as much about choosing a partner that offers a continuous partnership approach by working closely with customers to ensure their systems implementations succeed.

About the author
Brian Biggs is Director, Customer Relations and Sales, New Zealand for InterSystems, a creative data technology provider dedicated to helping customers solve the most critical scalability, interoperability and speed problems. Based in Auckland, Biggs leads the company’s New Zealand operations, providing local resources to a growing customer base and ensuring that InterSystems is responsive to their needs

If you would like to provide feedback on the above feature article please contact the editor Rebecca McBeth.

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