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Presented by
Global Forum for Health Care Innovators
The chief executive’s role in digital strategy
Leading digital transformation
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
2
Source: Morse S, “US health IT investment skyrockets to $7.1 billion,” Healthcare IT News healthcareitnews.com/news/us-
health-it-investment-skyrockets-71-billion; Hughes O, “NHS digitisation expected to cost up to £13bn – report,” Digital Health, digitalhealth.net/2018/10/nhs-digitisation-expected-to-cost-up-to-13bn-report/; “Has My Health Record been a sensible use of $2
billion?,” AudDoc, January 2019.ausdoc.com.au/news/has-my-health-record-been-sensible-use-2-billion-0.
Global Forum for Health Care Innovators interviews and analysis.
2017 Health IT investments:
$7.1 billion USD
NHS digitisationexpected costs:
£13 billion
Cost of My Health Record:
$2 billion AUD
There is a lot riding on this
Health care specific investments in digital transformation
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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1. Total spend was $1.3T.Source: Zobell S, “Why Digital Transformations Fail: Closing the $900 Billion Hole in Enterprise Strategy,” Forbes 2018
f orbes.com/sites/forbestechcouncil/2018/03/13/why-digital-transformations-fail-closing-the-900-billion-hole-in-enterprise-strategy/#5fc7aa057b8b.
Global Forum for Health Care Innovators interviews and analysis.
And we’re missing the mark
Amount of money spent on
failed digital transformation
projects in 20181
$900B70%Digital transformation projects
that miss their goals
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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Source: Chase Farm Hospital, Royal Free London NHS Foundation Trust, England, UK.
Comprehensive transformation at Chase Farm Hospital
An ambitious journey
Global Forum for Health Care Innovators interviews and analysis.
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
Case in brief
5
• In 2014, Chase Farm was acquired by Royal Free London and a significant
redevelopment process was undertaken. Upon completion in 2018, the hospital was the most digitally advanced organisation in the UK.
• As part of the redevelopment process, the hospital focused on reducing
variation, improving patient experience, and releasing time to care.
• As a purpose-designed paperless hospital, the clinically-led digital transformation process focused on improving existing processes and
introducing digital solutions for new and existing challenges. A major focus of work has been on developing and digitising new care pathways in the
system-wide EPR1.
50-bed acute hospital providing primarily elective services in
England, UK. Part of the Royal Free London NHS Foundation
Trust. Serves a population of one million.
Chase Farm Hospital
1. Electronic Patient Record.
Global Forum for Health Care Innovators interviews and analysis.
Source: Chase Farm Hospital, Royal Free London NHS Foundation Trust, England, UK.
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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Royal Free London’s ‘group vision’
Global Forum for Health Care Innovators interviews and analysis.
Royal Free’s aspiration is to be Europe’s best performing health care group
Focus
Values
Mission
Governing objectives
Source: Chase Farm Hospital, Royal Free London NHS Foundation Trust, England, UK.
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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A digital element for every focus area
Global Forum for Health Care Innovators interviews and analysis.
Digitised pathways
Integrated into the EPR, redesigned
pathways streamline patient care
Planned digital
pathways, with seven already done
40Reduction in
preventable escalation
5%
RespiraSense Digital
Monitoring device identifies respiratory
deterioration 12 hours earlier
Cerner EPR
Centralised patient information into
single record
“I’m pretty happy about
how it’s enhanced my day-to-day, work freeing
up precious time.”
- Anonymous doctor
Cancer pathway
One of the first cancer pathways
to be fully digitised
“What’s the point of
going private when you can get care like
this in the NHS?”
- Anonymous patient
Online self roster
Provides greater shift choices to staff across
the organisation
Reduction in staff
turnover across Royal Free London
30%
Source: Chase Farm Hospital, Royal Free London NHS Foundation Trust, England, UK
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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And not stopping at big focus areas
Global Forum for Health Care Innovators interviews and analysis.
Digitally enabled solutions introduced at Chase Farm Hospital
• New single patient rooms made it more
difficult for nurses to safely monitor patients
• Hospital felt they might need to hire more nurses, but cost was prohibitive
Identified challenge
• New hospital design has fewer registration
desks for patients to use, ask questions
• Patients may not know where to go upon arrival or where to wait for care
• New care pathways introduced more
ambitious treatment, recovery timelines
• Clinicians uncomfortable with the level of risk associated with new pathways
SP
AC
EP
AT
IEN
TS
ST
AF
F
• Invested in Ascom digital call system
in patient rooms
• Nurses carry hand-held device, can speak with patients from anywhere in hospital
• Electronic registration directs patients to
most appropriate, least crowded waiting area
• Screens throughout hospital notify patients when they need to go to appointment
• Clinicians able to access patient records,
real-time status from anywhere
• Care pathways embedded into EPR, prompt clinicians to follow standards
Implemented solution
Source: Chase Farm Hospital, Royal Free London NHS Foundation Trust, England, UK.
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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Plotting your approach to digital strategy
Global Forum for Health Care Innovators interviews and analysis.
Digital as
stand-alone strategy
Digital embedded as
part of every strategy
2 3 41 5
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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Source: Behnam Tabrizi et al., “Digital Transformation is Not About Technology,” Harvard
Business Review 2019, hbr.org/2019/03/digital-transformation-is-not-about-technology.
A known secret across industries
Global Forum for Health Care Innovators interviews and analysis.
Digital transformation worked for [successful] organisations because
their leaders went back to the fundamentals: they focused on
changing the mindset of its members as well as the organisational
culture and processes before they decided what digital tools to use
and how to use them. What the members envision to be the future of
the organisation drove the technology, not the other way around.
—‘Digital Transformation is Not About Technology’
Harvard Business Review, 13 March, 2019
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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What we have to get right…
Global Forum for Health Care Innovators interviews and analysis.
There is no digital plan,
it is part of every plan
Executive imperatives for securing return on digital investment
Frontline technology
adoption is usually more
about will than skill
Skew towards narrow
solutions over long term
investment plans
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
12
1. London North Eastern Railway.
Jumping the tracks
Global Forum for Health Care Innovators interviews and analysis.
…undermined by existing infrastructure, processes
Ambitious plans to roll out new technology…
New trains are
designed to reach top speeds of 140mph
Incompatibility with existing
infrastructure delayed roll-out and increased costs
Trains only able to
travel at a top speed of 125mph due to
track restrictions
LNER1 expects peak
capacity will increase by 28% from Kings Cross
LNER was the worst
performing train service in 2018 due to 5% of trips
experiencing serious delays
Leadership plans to
introduce more services and tempt passengers
away from airlines
Source: Simon Calder, “Inside the New Azuma Trains Running from London to Leeds,” Independent independent.co.uk/travel/news-and-
adv ice/azuma-lner-new-trains-east-coast-main-line-railway-a8913356 .html;%20; thetrainline.com/train-companies/london-north-eastern-railway/azuma
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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Three steps to unfence your digital efforts
Global Forum for Health Care Innovators interviews and analysis.
The three ‘t’s of transformation
Translate Tradeoff Track
Key lesson:
To make the most of digital for your organisation, start with key
objectives and then ask how digital can help you get there
Key lesson:
If digital will be part of many initiatives then you’ll need
ways to prioritise resources and decide where to focus
Key lesson:
When digital is a critical enabler for strategies, its impact needs
to be measured both in termsof processes and outcomes
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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Does your strategic plan look like this?
Global Forum for Health Care Innovators interviews and analysis.
1. Pseudony m.
New Forrest1 Community NHS FT - Digital Strategy 2018-2021
Translate
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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Source: NHS North West London, England, UK.
What it should look like on paper
Global Forum for Health Care Innovators interviews and analysis.
North West London Strategic STP1 Plan
NO
RT
H W
ES
T L
ON
DO
NC
CG
S
1. Sustainability and Transformation Partnership.
Document starts with clearly outlined strategic priority
Digital work streams mapped to enterprise goal
Digital solutions identified as enablers of broader goal’s success
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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1. Accountable Care Organisation.Source: Bill Siwicki, “How a pop health platform helped one ACO prevent 98 strokes and 39 heart attacks in less than a year,” Healthcare
IT News, 2019 healthcareitnews.com/news/how-pop-health-platform-helped-one-aco-prevent-98-strokes-and-39-heart-attacks-less-year.
Population health goal with a digital element at Arizona Care Network
What it should look like in practice
Global Forum for Health Care Innovators interviews and analysis.
Results of data-driven care coordination
3,00098Strokes prevented in a year
Shared intelligence across network sites
Improved patient outcomes
Digital solution enabled enterprise goal
Creation of N Compass
to stratify, track patients
39Heart attacks prevented in a year
Provider prioritises population health
Vulnerable patients
overlooked due to sheer volume of
network’s patients
Decision to focus
on rising risk
N Compass, the ACO’s1
care coordination division, identified rising risk patients
using data and analytics
N Compass created a single operational data source available to all clinicians to track patient progress
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
Case in brief
17
• The network sought to improve care coordination for rising risk patients
as they calculated about 3,000 patients were being overlooked yearlydue to the high volume of patients in the network.
• They created a care coordination division called N Compass, which
identified and tracked rising risk patients using data and analytics. This produced a single operational source of information for doctors to use
across the network.
• Efforts contributed to prevention of 98 strokes and 39 heart attacks in one year by identifying at-risk patients early in their disease progression.
Accountable Care Organisation of 5,500 health care
providers owned by doctors in Arizona, United States.
Arizona Care Network
Source: Arizona Care Network, Arizona, USA.
Global Forum for Health Care Innovators interviews and analysis.
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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1. Local Health and Care Record Exemplars.
2. Global Digital Exemplar Source: Salf ord Royal NHS Foundation Trust, England, UK.
Salford Royal received technology requests from all corners
Once you unfence digital, how do you manage all requests?
Global Forum for Health Care Innovators interviews and analysis.
Tradeoff
Staff operational requests
GDE2 programme requirements
Chief Executive requests
Board innovation
requests
System strategic requests
Follow-up appointment
scheduling
Pre-admissions support app
LHCRE1 data sharing
Video consultations
Partnership with new vendors
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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Salford Royal subjects all requests to the same process
Global Forum for Health Care Innovators interviews and analysis.
Sources of digital requests
C-suite requests
Staff requests
GDE requirements Documents submitted
to the Portfolio Board
Documents reviewed by
board and decision made
Identification
Decision ratified by Trust
Executive via Executive Board
1
2
3
4
Digital approval governance process
Problem and benefits
statement prepared
Justification
Review
Ratification
Source: Salf ord Royal NHS Foundation Trust, England, UK.
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
Case in brief
20
728-bed acute teaching hospital in Salford, England, UK. Part of the Northern
Care Alliance, a five-hospital integrated care organisation. Serves a
population of one million.
Salford Royal NHS Foundation Trust
Source: Salf ord Royal NHS Foundation Trust, England, UK.
Global Forum for Health Care Innovators interviews and analysis.
• In 2016, the trust was selected as one of the original acute Global Digital Exemplars
(GDE). As part of the GDE programme, the trust needed to complete 37 projects under four key themes in two years. In addition, they still needed to fulfil technology and innovation
requests from the staff, Board, and system. The volume of requests made it difficult for leaders to efficiently decide which digital innovations to explore.
• Salford Royal enforced a consistent governance process for all digital innovation requests
regardless of source. Steps include preparing a problem and benefits statement, submitting justification documents to the Portfolio Board for review, and finally ratification by the
Executive Board.
• The trust’s governance system proved so efficient that they tested over 75 innovations in one year and welcomed over 2,000 visitors to test digital solutions.
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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1. Pseudony m.
2. Personal health records.
3. Electronic medical records.
Oak FT1 sought buy-in from all system sites for PHR2 roll-out
Global Forum for Health Care Innovators interviews and analysis.
Pregnant women seek care at many sites
Other women’s services
“Hand-held”
maternity notes
Digital PHR for maternity services links up sites
Care disjointed and
duplicated due to analog patient records
Cloud-housed
PHR platform
Patient engagement
poor due to lack of dedicated provider
• Pregnant women
expected to carry notes from different
providers to each visit
• High probability of
care discontinuity
• Records attached to separate hospital
EMR3 systems
• Records accessible
on multiple devices
• Records available to
patients, as well as providers across sites
• Records housed in
Cloud, not linked to EMR
Track
Antenatal care
Postnatal care
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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1. Key perf ormance indicator.
2. Local Maternity System.
Oak Foundation Trust’s comprehensive KPI1 assessment elevates impact
Integrated metrics used to evaluate success of PHR initiative
Global Forum for Health Care Innovators interviews and analysis.
Indicators of success
• Number of women who initiate self-referral using PHR
• Improvement in patient satisfaction
Financial metrics
• Return on initial investment
• Midwives time saved
Digital metrics
• Number of patients using PHR
• Amount of data collected in the PHR
/
Trusts in the
LMS2 agreed to
create PHR for
maternity services
4
Example of KPIs used to evaluate success of maternity PHR
Patient impact
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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What we have to get right…
Global Forum for Health Care Innovators interviews and analysis.
Executive imperatives for securing return on digital investment
Skew towards narrow
solutions over long term
investment plans1. Translate digital vision
into strategic priorities
2. Make tradeoffs to maximisescarce resources
3. Track metrics differently
to reflect integration
Frontline technology
adoption is usually more
about will than skill
There is no digital plan,
it is part of every plan
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
24
So
urc
e:
“Dig
ita
l tra
nsf
orm
ation
,” M
ark
eto
on
ist, S
ep
tem
ber 2
01
9.
Global Forum for Health Care Innovators interviews and analysis.
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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Exploit non-linear nature of success by building in ‘gut-checks’
The path of progress never did run smooth
Global Forum for Health Care Innovators interviews and analysis.
Pro
gre
ss
Time
Expected path of success Actual path of success Ideal path of success
Feedback moments offer opportunities to course correct
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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Four guiding principles to improve execution
Global Forum for Health Care Innovators interviews and analysis.
Invest in solutions that fit your
organisation
Critically assess technology investments—no
matter the size—to make sure they solve problems and work in your specific environment
Polish processes before digitising
Optimise current technology and manual
processes before investing in new resources
Know what your end users want
Incorporate diverse perspectives—including
clinicians, patients, and families—to ensure digital solutions meet the needs of all users
Don’t overcommit to one defined path
Seek out investments or develop capabilities that
will allow you to add and scale capabilities as needs change and technology improves
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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1. Artif icial intelligence.
2. Radio-f requency identification.
No shortage of potential investments
Global Forum for Health Care Innovators interviews and analysis.
Optimise Your Trust’s Website Today!
New Digital Kiosks!
Does Your Hospital Have AI1?
How Geolocation Changes Health Care
Machine Learning and Health Care
Your Patients Should Be Using Wearables!
New in Healthcare: Virtual Health
Top 5 Trusts with New Facilities
Why Your Trust Needs Better Wi-Fi
Engage Patients with these Social Media Tips!
Need to Know on RFID2 Chips
The Newest Innovations for Your EPR!
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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Alder Hey sought input from patients to scope investments
Know what your end users want
Global Forum for Health Care Innovators interviews and analysis.
Source: Alder Hey Children’s Hospital, England, UK.
AlderPlay Application
includes a 3D guided tour of the hospital to alleviate
patient fears
Scoping the solution
Immersive technology
supports distraction and education of children
“I don’t always know what
to expect when I come into the hospital”
“I was scared by the saw
used to remove my plaster”
Input from children and young people Scoping the problem
Patients want to
understand hospital experience before
admissions
When in hospital,
patients want to be distracted during
minor procedures
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
Case in brief
29
• To better serve their patients, Alder Hey developed an investment
strategy that reflected the voices of patients and families by leveraging their children and young people’s forum to pressure test what patients
and families needed as they stayed in the hospital.
• As a result of their findings, they have ensured free Wi-Fi access for children, young people, families, and visitors, and developed an
AlderPlay App that distracts children and provides parents the opportunity to familiarise themselves with the hospital in advance of visit.
309-bed children’s specialist hospital in West Derby, Liverpool,
England, UK. Serves a population of 330,000.
Alder Hey Children’s Hospital
Global Forum for Health Care Innovators interviews and analysis.
Source: Alder Hey Children’s Hospital, England, UK
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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1. Millimeters of mercury; a manometric unit of pressure. Source: Emory Healthcare, Georgia, USA.
Emory Healthcare refined sepsis criteria to yield better results
Polish processes before digitising
Global Forum for Health Care Innovators interviews and analysis.
Trigger criteria for suspected sepsis infection
Indicator Original Standard New Standard
Hypothermic temperature
36° C 35° C
Heart rate >90 / minute >110 / minute
Respiratory rate >20 / minute >22 / minute
Mean arterial pressure (MAP)
n/a <65mmHG1
Systolic blood pressure
n/a <90 mmHG
Emory refined criteria to become more exclusive and reduce false-positives from original standard
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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Emory then automated screening questions to aid nurses in critical periods
Digital solutions should make our job easier
Global Forum for Health Care Innovators interviews and analysis.
Automated questions for suspected sepsis cases
Suspected Sepsis Alert
Your patient has screened positively for suspected sepsis. Take the following immediate actions:
1. Call ‘code sepsis’
2. Notify clinician of thepositive screen
3. Activate initial PowerPlanfor suspected sepsis
Sepsis Screening
1. Do you suspect a
new or worsening infection within the
last 48 hours?
2. Are signs and
symptoms of infection both present and new?
x x Yes
No
Yes
No
Source: Emory Healthcare, Georgia, USA.
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
Case in brief
32
• Started sepsis care variation reduction initiative in 2014, along with spine,
bowel procedures, and heart failures.
• System-wide sepsis initiative decreased mortality, lowered length of stay, and saved $1.8M annually through process improvement and
standardisation.
• Sepsis care variation reduction team lead awarded ANCC1 National Magnet Nurse of the Year in 2017 for transformational leadership.
Seven-hospital teaching research hospital based in Atlanta,
Georgia, US with 2,000 providers.
Emory Healthcare
1. American Nurses Credentialing Centrer.
Global Forum for Health Care Innovators interviews and analysis.
Source: Emory Healthcare, Georgia, USA
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
33
Source: Salf ord Royal NHS Foundation Trust, England, UK.
Invest in solutions that fit your organisation
Global Forum for Health Care Innovators interviews and analysis.
Salford Royal’s technology evaluation process
Identify
Deploy
Live Test
Lab Test
VisualiseTrials projects that can be rolled-out in hospital environments
Digital Factory
Provides projects the ability to simulate exchange of data
safely, securely and reliably
Works with innovation vendors to develop custom-made
solutions for organisation-specific problems
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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Digital Factory helps Salford Royal save time and money
Digital Factory finds Alexa not ‘fit-for-purpose’
Global Forum for Health Care Innovators interviews and analysis.
• Alexa proposed as way to automate admissions,
discharges and transfers (ADT)
• Device would transcribe clinician notes in real
time and make bed management more efficient
Identified potential solution
• Digital Factory simulated A&E environment
• Alexa couldn’t transcribe interactions due tonoise levels
Put through Digital Factory
• Realised Alexa was not fit-for-purpose
• Did not move forward with proposed solution
Save time and money
Source: Salf ord Royal NHS Foundation Trust, England, UK.
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
Case in brief
35
• In 2016, the trust was selected as one of the original acute Global Digital Exemplars
(GDE). As part of the GDE programme, the trust needed to complete 37 projects under four key themes in two years.
• In addition to the consistent governance system, Salford Royal transformed their triage
process to streamline digital requests in a controlled and organised manner through a five-step process: Identify, Visualise, Lab Test, Live Test, and Deploy.
• As part of the ‘Lab Test’ phase, they built an in-house Digital Factory that allows them
to simulate the desired hospital environment, allowing them to test 75 potential solutions to date.
728-bed acute teaching hospital in England, UK. Part of the Northern Care
Alliance, a five-hospital integrated care organisation. Serves a population of
one million.
Salford Royal NHS Foundation Trust
Global Forum for Health Care Innovators interviews and analysis.
Source: Salf ord Royal NHS Foundation Trust, England, UK.
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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Imagine this at the enterprise scale
Global Forum for Health Care Innovators interviews and analysis.
SO
UR
CE
: C
DW
SO
UR
CE
: TE
CH
RA
DA
R
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
37
1. Pseudony m.
Oak Foundation Trust’s1 incremental adjustments over time
Global Forum for Health Care Innovators interviews and analysis.
Don’t overcommit to one defined path
Total integration
Decentralised
management
Build systems
Closed system
Purchase systems
Centralised
management
Total overhaul
Open system
Time
Choice A Choice BDecision
“What type of system architecture do we want?”
“How do we get the systems to work together?”
“How do we manage the overlaps?”
“How should we obtain this new function?”
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
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• Manages integration engine
and builds needed functions
• Interface platform connects
systems that are unable to communicate
• Enables the addition
of new systems
• In-house platform provides
digital aid for 20+ clinical subspecialties
• Prevents need for
buying new systems
Global Forum for Health Care Innovators interviews and analysis.
How Oak FT makes the most of integration expertise
Integration TeamIntegration
Engine
Clinical Support
System
Oak FT’s integration infrastructure
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
39
What we have to get right…
Global Forum for Health Care Innovators interviews and analysis.
Executive imperatives for securing return on digital investment
Skew towards narrow
solutions over long term
investment plans
4. Understand what your end users
value in digital capabilities
5. Optimise digital processes to ensure you don’t perpetuate
poor practice
6. Ensure that digital solutions meet organisational needs
7. Seek out investments that allow
you to add and scale capabilities as your organisation evolves
Frontline technology
adoption is usually more
about will than skill
There is no digital plan,
it is part of every plan
1. Translate digital vision
into strategic priorities
2. Make tradeoffs to maximisescarce resources
3. Track metrics differently
to reflect integration
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
40
Source: Shah S, et al., “Leading Change—A National Survey of Chief Innovation Officers in Health Systems,” Health Management Policy and
Innovation, 3, no. 1 (2018) hmpi.org/2018/03/14/leading-change-a-national-survey-of-chief-innovation-officers-in-health-systems/; Tabrizi B et al., “Digital Transformation is Not About Technology,” Harvard Business Review 2019 hbr.org/2019/03/digital-transformation-is-not-about-technology.
Will overtaking skill as barrier to success
Global Forum for Health Care Innovators interviews and analysis.
Time
Technological change
Human capacity to change
We are here
Rate of technology change exceeds human capacity to adapt
Time
Rate
of chang
e
of innovation executives said the biggest barrier to innovation is culture and organisational structure1
64%
When employees perceive that digital
transformation could threaten their jobs,
they may consciously or unconsciously
resist the changes.”
–Harvard Business Review
DATA SPOTLIGHT
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
41
Help staff adapt to new reality, way of working
Global Forum for Health Care Innovators interviews and analysis.
Humanise the “why”
3
Tell your digital transformation
story in a compelling manner
2Invest in a Chief
Translation Officer
Expand what you need from
your IT leadership
Three key lessons in transforming digital care culture
1Meet people
where they are
Tailor the message to the
right audience
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
42
1. Integrated electronic Medical Record.
Tailor the message: Clarify connection between digital care and frontline values
Meet people where they are
Global Forum for Health Care Innovators interviews and analysis.
1Executive
team
Digital Hospital
adoption services
42Clinical
Advisory Group
3Change
champions
C-Suite managing
roll-out planning, implementation team,
and status updates
5Frontline
staff
Doctor champions
serving as clinical voice; meet
weekly to address implementation issues
Specially trained staff
providing communication and
educational support to their units and
divisions
IT workers providing
specialist system knowledge to support
clinical practice
Clinicians using new
ieMR to provide safe, high-quality, and efficient
care day-to-day
ieMR1 roll-out process includes all stakeholders
Source: Metro South Hospital and Health Services, Queensland, Australia,
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
43
Source: Metro South Hospital and Health Services, Queensland, Australia,
Metro South’s executives empowered change champions to deliver the message
The voice of a peer can be more convincing to a sceptic
Global Forum for Health Care Innovators interviews and analysis.
Training details
Badge 1: Super UserBadge 2: Super User +
Add-On Training
Change champions
training programme
Badge level
• 8 hours of training
• 800 individuals
• Can tend to basic
support questions and issues
• Twelve hours of training
• 200 individuals
• Able to answer specific
service line and technological questions
Two levels of change champions
Change Champion role description
• Maintain visibility in
hospital to respondto ieMR complaints
• Communicate
department feedback
• Assist with implementation prep
Acute sites
covered by ieMR5
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
Case in brief
44
• As part of a Queensland initiative, began a system-wide ieMR roll-out in 2014 at
Princess Alexandra Hospital before expanding ieMR to their four other acute sites.
• Roll-out process includes stakeholders from all levels of the organisation, including the executive team, Clinical Advisory Group, Digital Hospital adoption
services, and frontline staff—allowing for the transformation message to be tailored to each group.
• Utilised ‘change champions’ to uncover pain points, provide frontline support, and
report back to system leadership during implementation.
Five-hospital health service in Queensland, Australia. Serves
a population of one million, of 23% of the State.
Metro South Hospital and Health Services
Source: Metro South Hospital and Health Services, Queensland, Australia,
Global Forum for Health Care Innovators interviews and analysis.
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
45
Identify and empower a Chief Translation Officer
Global Forum for Health Care Innovators interviews and analysis.
• Effectively leads the IT team
• Communicates importanceof technology to senior leaders
• Speaks technical language
• Liaises between theIT and executive teams
• Understands digital in the context of wider organisational priorities
IT Leader Chief Translation Officer
• Communicates digitaland enterprise visionto entire organisation
• Advocates for strategicplans to the C-suite
• Well-versed in system goals
Past Today Future
Expanding definition of IT leadership
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
46
1. Leadership success factors adapted from the College of Healthcare Information
Management Executives (CHIME) Health Care IT Leadership Academy curriculum.
2. Healthcare Information Technology.
Cleveland Clinic’s Business Technology Leadership Academy (BTLA)
You may need to groom that talent
Global Forum for Health Care Innovators interviews and analysis.
RESULTSPLANNING PARTICIPATION
Identify future leaders
Programme application
• Open to everyone
• Applicant required to submit
one-page essay on why they should be chosen to participate
Participant selection
• Senior leadership team reviews applications
• Ten participants chosen from hundreds of applicants each year
Participants learn eight leadership
success factors1
1
3Participants complete capstone
leadership project
Participants receive mentorship from
faculty and senior leadership
2
Leadership skill development
• Set vision and strategy
• Make change happen
• Demonstrate IT’s business value
• Instill customer service as a core value
• Build a high performance IT organisation
• Build networks and community
• Contemporary best practices in HIT2 industry
Graduates serve as faculty
for future BTLA programmes
Source: Cleveland Clinic, Ohio, US.
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
47
Digital transformation has a story
Global Forum for Health Care Innovators interviews and analysis.
This is why our community
should care about our digital transformation…
This is how it improves the lives
of our patients and caregivers…1 2
This is what the journey
looks like…3 This is how everyone will
feel when it is complete…4
How one CEO shared her vision
• Make it simple—she put her strategy in a visual one piece of paper
• Reach everyone—she met with all 500 leaders face-to-face in small groups
• Help them see—she told compelling, human stories
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
49
What we have to get right…
Global Forum for Health Care Innovators interviews and analysis.
Executive imperatives for securing return on digital investment
Skew towards narrow solutions
over long term investment plans
4. Understand what your end users
value in digital capabilities
5. Optimise digital processes to ensure you don’t perpetuate
poor practice
6. Ensure that digital solutions meet organisational needs
7. Seek out investments that allow
you to add and scale capabilities as your organisation evolves
Frontline technology adoption is
usually more about will than skill
8. Provide peer support to staff and
answer specific questions about digital transformation
9. Invest in a thought partner who
can help translate the digital message across the entire
organisation
10. Make the case for digital in a way that humanises technology
There is no digital plan,
it is part of every plan
1. Translate digital vision into
strategic priorities
2. Make tradeoffs to maximisescarce resources
3. Track metrics differently to
reflect integration
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
50
Source: Chase Farm Hospital, Royal Free
London NHS Foundation Trust, England, UK.
Lessons from Chase Farm’s Chief Executive Officer
What it takes to lead digital transformation
Global Forum for Health Care Innovators interviews and analysis.
Confidence
Don’t second guess your choices. You are asking staff to take a leap of
faith and fundamentally change the way they work. Trust your decisions.
Commitment
Avoid the temptation to slip back into old ways of doing something or
abandon a project because it isn’t going to plan.
Consistency
Maintain the party line, in messaging and decisions. To ensure you
achieve your vision, you must keep focus on core principles.
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
51
What we have to get right…
Global Forum for Health Care Innovators interviews and analysis.
Executive imperatives for securing return on digital investment
Skew towards narrow solutions
over long term investment plans
4. Understand what your end users
value in digital capabilities
5. Optimise digital processes to ensure you don’t perpetuate
poor practice
6. Ensure that digital solutions meet organisational needs
7. Seek out investments that allow
you to add and scale capabilities as your organisation evolves
Frontline technology adoption is
usually more about will than skill
8. Provide peer support to staff and
answer specific questions about digital transformation
9. Invest in a thought partner who
can help translate the digital message across the entire
organisation
10. Make the case for digital in a way that humanises technology
There is no digital plan,
it is part of every plan
1. Translate digital vision into
strategic priorities
2. Make tradeoffs to maximisescarce resources
3. Track metrics differently to
reflect integration
© 2019 Advisory Board • All rights reserved • advisory.com • WF1430991
Credits
52
Sarah Rindone
Design Consultant
Ashley Ford, Managing Director
Vidal Seegobin, Practice Manager
Programme Leadership
Asya Igmen
Jaren Kirkland
Research Team
+44 (0) 203 100 6810
Liz Roberts, MSc
Project Director
Global Forum for Health Care Innovators
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