By Tom Sullivan, Healthcare IT News | May 6, 2019
It’s a matter of change management – and there are some applicable best practices.
Digital transformation. It sounds daunting and absolutely essential because it’s both.
HIMSS Media research, in fact, found that it’s a top priority for healthcare professionals but thus far fewer than 10 percent have executed a full digital strategy.
The current state of healthcare digital transformation, in fact, is fragmented. One-third of our survey participants are making enterprise-wide changes, another third are still collecting information with which to formulate a plan and the rest are progressing at the departmental or use case level. Only about 2 percent have no plans or are taking no action at this time.
Those who have yet to transform themselves digitally should know that it’s a change management issue more than anything else and best practices exist that can be applied in healthcare.
Smart digital hospital of the future
“Whether it’s retrofitting hospitals or building new ones, digital transformation is fundamentally about improving patient experience,” said Michael Monteith, CEO of Thoughtwire, which sells software for smart buildings including hospitals. “It’s about safety for patients and staff and cost-effectiveness — which is where the building and the business come together in a powerful way.”
That doesn’t mean it’s easy but there are some project and change management principles that can be applied to the effort.
Digital transformation is really a five-step process, according to Brendon Buckley, healthcare technology director at Johnson Controls, which works with healthcare and other industries to create intelligent buildings.
1. Start with a baseline. This means looking at what you already have in place, including existing legacy systems. It’s not about the EHR either, Buckley said, this also includes patient engagement tools, real-time location systems and telemetry, to name just a few. When you’ve done that, evaluate what’s working well and what could be improved. “Take a clinical, IT and facilities perspective,” Buckley advised. “You have to look at all three.”
2. Conduct a needs assessment. Once you get clinical, IT and facilities on the same page, the next step is to involve the design team in prioritizing each department’s wish list within the budget. Buckley recommended talking about the art of the possible and future-proofing while also making it clear that not everyone will get 100 percent of what they want. Then nail down the metrics, such as ROI, HCAHPS scores, staff and patient safety satisfaction, among others. After that, determine how to use technology to achieve those key performance indicators. “You have to have voting and consensus throughout the whole process so it doesn’t get derailed by pet projects,” Buckley added. “Integrating people and vision is harder and way more critical than integrating technologies.”
3. Build out the technology and process roadmap. This begins by working with the design team on tech and process mapping to determine what you can solve with a process, what really needs a new technology or, more likely than not, will require a combination of the two. Then it’s time to move forward with an integrated delivery methodology. “Build plans to test out and document the integration down to database, table, record, field level,” Buckley said. “Then communicate that out to everyone.”
Buckley added that the most important question people tend not to ask in the mapping process is: We know who owns the project and different pieces — but who owns the integration?
4. Execute and deliver. It’s critical to mind your details, keep the project on track and move all the way toward your initial vision, ensure KPIs are being met, and make sure no one is operating in a vacuum or undertaking any unilateral decision making. “You make one decision and there’s a cascading impact to at least two or three downstream areas,” Buckley said. For instance, deploying one new system could impact interoperability with other systems already in place, such as RTLS or a Wifi network. “You jeopardize a lot. Little workaround can turn a project to save $150,000 into a $300,000 sink. IT infrastructure decisions made that should have no impact, all too often do. Hospitals need to understand what those are.”
5. Ensure ongoing holistic services and support. The first phase is integration testing because if something breaks, particularly in the first two weeks, Buckley said it’s more likely to be the integration than the technology. You need a single point of responsibility for various tools, RTLS, EHR, nurse call, and others. “That single point of responsibility that cannot blame anyone else should be a combination of biomed, clinical and IT people because it’s touching all of them,” Buckley added. “If there is a heavier player in it, the one coordinating all this, that would most likely be IT.”
Don’t let progress decay
The most critical point is to understand change management processes, establish support services into the future, track metrics for what success means and communicate the importance of what you’re doing.
“Focus on mobility, engaging people, having tech that improves their workflows as opposed to becoming another source of burden,” said Monteith.
“Staff has to see the value,” added Buckley. “You have to make their job easier, safer, better or why do it?”