Digital transformation for quality and safety

Australia has a profound shortage of practising clinical informaticians, required to help transform siloed digital healthcare systems into system-wide networks.

Australia has a world-class health system that delivers excellent outcomes. However, traditional methods for delivering healthcare are not sustainable; demand is exceeding the capability of our system, and issues with quality and safety inflict avoidable harm and unnecessary cost.

Improving the system involves a clear articulation of the Institute for Healthcare Improvement’s quadruple aim for modern health care: to improve the quality of care, the efficiency of care, population health and the experience of our patients and their carers. Achieving such complex aims is nearly impossible with traditional healthcare delivery.

Historically, health care is based on paper-based systems or siloed digital systems. These systems were deployed with the aim of delivering discrete episodes of care for individual patients and are not fit for the purpose of tackling system-wide quality improvement initiatives.

A healthcare delivery platform should be fit for the purpose of enabling data-driven decision-making to improve care at scale, and not just the delivery of discrete episodes of care to individual patients. It forms the foundation for:

• benchmarking of performance and patient outcomes using standardised digital data points collected by clinical staff as part of routine care;
• linkage of the data for each patient across the continuum of care in different healthcare settings;
• an ability to present meaningful clinical data to frontline staff and system managers in real time to enable immediate intervention to improve outcomes;
• a platform that enables new and innovative models of care, eg, virtual consults, patient portals.
   

These requirements can only be delivered by an integrated digital healthcare system spanning the continuum of patient care. This digital transformation of hospitals involves two components:

1. The technical rollout of an integrated electronic medical record, and integrated devices such as vital sign monitors and blood glucose monitors. This is achieved by projects heavily led by technical expertise, with clinical consultation.
2. The digital transformation of clinical care (workflows, culture and clinical governance) to leverage the digital system towards goals of quality and safety improvement of the whole system, rather than just digital delivery of individual episodes of patient care. This requires leadership by trained clinical informaticians with expertise in data-driven system improvement, digital workflow redesign, culture transformation, clinical governance and strong technical support.

Across the world, most efforts have focused on the first component; however, in order to deliver a return on investment, attention is now turning to digital transformation of clinical care rather than the simpler rollout of a software system.

Digital transformation is much more than a technical rollout and requires different skill sets for success. Technical rollout requires change management and technical expertise; however, digital transformation requires trained clinical informaticians with expertise in large-scale, system-wide quality and safety improvement and change leadership.

Australia has a profound shortage of practising clinical informaticians, particularly in digital quality and safety system improvement. National investment and development in this emerging workforce will be critical to ensure the healthcare system is futureproofed and continues to deliver evidence-based, sustainable, high-quality care for all Australians.

Co-authors*:

Dr Clair Sullivan, Consultant Endocrinologist and Medical Informatician, Chief Digital Officer, Metro North Hospital and Health Service

Amy Barnett, Co-Director Digital Healthcare Delivery. B.Hlth (Nursing), Grad.Dip HlthServMgt, MPH, CHIA

Michelle Winning, Co-Director Digital Healthcare Delivery. B.Nurs (Hons), CHIA

Lynne Wall, Co-Director Digital Healthcare Delivery. B.Nurs (Hons)

Dr Andrew Staib, Emergency Physician and Co- Director Healthcare Innovation and Transformation Excellence Collaborative

*All the co-authors of this story are members of the Healthcare Innovation and Transformation Excellence Collaborative, Clinical Excellence Queensland Health.

Image credit: ©stock.adobe.com/au/Kaspars Grinvalds