Digital transformation can sometimes seem like the emperor’s new clothes. It’s the thing that everyone is doing and everyone is interested in yet sometimes hard to define and to quantify. In healthcare this is not that different to any other industry. The dialogue on digital transformation in many other sectors focussed on the domains of the Chief Information Officers (CIOs) and Chief Digital Officers (CDOs). CIOs and CDOs is many sectors have described some of the tensions of driving digital transformation.
Making the case for digital transformation is itself complex, there will be uncertainty and unknown outcomes. It’s a sector that is moving at such pace that making predictions about the type of technology and the type of benefit is difficult and relies on a mixture of insights, evidence and global trends. Digital transformation will inevitably mean different things in different settings, the ability to transform will be depending on culture, technology, legacy and funding as well as competing interests and priorities.
Digital transformation opens up a whole new language and itself can lead to differences in understanding and outcome. We could simply assume that this is the fault of managers, decisions makers and digital leaders. Equally, the ground swell in the ecosystem of start-ups, SMEs and technology suppliers badging themselves under the umbrella of digital transformation can be equally confusing. Digital transformation has always been about significant transformation of activities and processes that capitalise on opportunities from digital technology. The impact of this change is intended to span society, it should be strategic and co-ordinated, i.e. there should be some sense of order.
In the context of healthcare, that digital transformation needs to move to the core of business, policy and strategy. It needs to be seen as the future of how the health system operates, it can no longer really be about specific individual projects but has to be about an enterprise type approach, almost a philosophy that spans the entire organisation.
Within the NHS as a type of federated organisation, this culture towards digital transformation needs to form part of the mindset of decisions makers throughout the health system. Already we have seen the impact on society and almost every industry by the adoption of mobile, social media, cloud and data. The rate and pace of development amongst accelerators is happening at speed perhaps not previously envisaged. These accelerators or emerging technologies include distributed ledger technology, artificial intelligence, extreme reality and quantum computing.
The next generation of technology is evolving at a faster rate than the previous generation. Digital transformation will rely on digital leaders and decision makers having a better understanding of emerging technology. This will require new partnerships, with healthcare leaders more willing to share problems and technology providers forming a different way of working offering openness and transparency in their capability.
Decision makers and leaders in healthcare need to be able to leverage on information that will help guide better decisions. In healthcare we have the added advantage of having CIOs, CDOs and CCIOs amongst many other types of digital leader that can offer advice. System leaders and policy makers don’t need to understand the specifics of the technology itself or decide on the technology outcome, but really need to be able to define the business, operational or health outcome they are seeking. Digital health leaders will need to be in a position where they can guide those discussions and advise on the impact of emerging technology.
In every sector, businesses are becoming digital businesses. It’s likely the same will emerge in parts of healthcare to a greater or lesser degree overtime. We are already seeing the emergence of this in different parts of primary care in the NHS, and its likely to be the case in diagnostic imaging before long. With this in mind, the scale of digital transformation may need to shift from something that is currently based on geography or single organisational unit to something that takes more of an enterprise approach – this will also require a shift that changes the entire culture of an organisation to thinking digital.
Healthcare has no shortage of leaders and certainly in the NHS, the governance of State is based on accountability and having senior responsible officers and accountable officers, none of this comes at odds with digital transformation but requires a different type of collaboration. CIOs, CCIOs, CDOs and other digital health leaders are relevant and necessary but more importantly digital transformation needs to belong to the whole organisation and to all leaders, supporting an approach where people can collaborate beyond organisational boundaries.
Within the NHS, digital projects have often started with single problems or single elements of the system. Digital transformation has to be more than this, it has to involve all parts of the system that are connected in some way, recognising the different types of user and stakeholders.
Digital transformation in healthcare is a significant change in the way we currently operate and is likely to evolve at pace; it offers an opportunity to take an enterprise approach to healthcare and improving outcomes.
Dr Sam Shah is director of digital development at NHS England.
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