Why the human factor is critical in digital transformation

Australia is seeing a wave of technological innovation that promises to increase productivity in health care in the wake of the pandemic and the staffing shortages and rising rates of burnout among health professionals that came with it.

The right technology has the potential to improve patient outcomes, optimise clinician workflows and secure cost savings. But all large-scale healthcare technology implementations also involve significant change.

And 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.

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

An ‘adaptive’, not ‘technical’ change

There is often a lack of acknowledgement that digital transformation is an ‘adaptive’ rather than a ‘technical’ change. This leads to the belief that digital transformation projects mainly involve hardware and software implementation. However, this is far from the 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. However, 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 challenging 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. 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 our global experience.

1. Work with the product, not against it

Healthcare leaders should maintain a flexible and open-minded approach while driving change. However, it is crucial for them to ensure that their organisations fully comprehend and remain committed to their rigorously vetted, 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 possess valuable experience and expertise in their technology and how to successfully implement it. However, providers may encounter difficulties if they attempt to make the product or supplier conform to their existing organisational workflows. These workflows are often paper-based and static, rather than evolving and adapting to work effectively with new technology.

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

2. Take individual impacts into account

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.

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. However, data first needs to be captured, and often the expectation is that care providers will be entering it.

Clinicians often express frustration with the amount of time they spend entering and viewing patient information instead of directly caring for their patients. To ensure successful digitisation projects, it is important to acknowledge and minimise this burden on frontline staff from the beginning, while also managing their expectations.

3. Engage with clinicians from the start

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 misled 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 health care are far more likely to succeed.

4. Ensure involvement of senior management

To succeed, change programs require strong leadership from senior-level executives, including the medical directors and board members. While these leaders may be focused on operational delivery and performance metrics, such as patient waiting times, it is important for them to also prioritise visibility into digital projects. Additionally, the support of the medical profession is crucial to success, making sponsorship from the medical director and CEO essential.

5. Ongoing partnership with providers

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 is optimised, functionality is improved, and there are increasing levels of adoption.

Innovation and change in health care 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.

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.

*Dr Emeline Ramos is a Physician Executive at InterSystems, a creative data technology provider dedicated to helping customers solve the most critical scalability, interoperability and speed problems. Emeline provides clinical leadership for the strategic planning, implementation and management of health information systems based on InterSystems technology and is responsible for maintaining strong relationships with key clinical stakeholders.

In a medical career spanning more than 20 years, Emeline has been a surgeon for the UK National Health Service, a clinical researcher for AstraZeneca EU, and worked as an information management clinical and research adviser for the Victorian Comprehensive Cancer Centre in Australia.

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