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Presented by Global Forum for Health Care Innovators The chief executive’s role in digital strategy Leading digital transformation

Leading Digital Transformation - Advisory · variation, improving patient experience, and releasing time to care. •As a purpose-designed paperless hospital, the clinically-led digital

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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

3

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

4

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

6

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

7

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

8

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

9

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

10

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

11

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

14

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

15

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

18

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

19

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

21

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

22

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

23

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

25

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

26

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

27

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

28

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

30

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

31

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

34

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

36

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

38

• 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

[email protected]

Liz Roberts, MSc

Project Director

Global Forum for Health Care Innovators

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