... & What the Health CIO Can Start to Do to Prepare.
We are going to look in high-level at just some of the technologies and innovations that would enable the evolution of the Hospitalisation treatment model or paradigm, including in terms of enabling clinical treatment for some long-term, acute conditions to be transitioned from the traditional hospital-care setting to now be safely delivered within the patient’s home.
Digitisation vs Transformation
However, as we start to think about how we evolve the hospitalisation-treatment model to now move care for some acute conditions into the patient’s home, we should also be intentional to define the type of evolution we're actually wanting to achieve? Achieving a digital transformation is not automatic, as I think is coming to be more clearly understood (within the health sector). Furthermore, a Hospital’s being ‘digital’ is often conflated with its having introduced an app, this, at a stretch ‘could’ perhaps be accepted as being one of the attributes, or ways in which being digital might manifest itself. However, introducing an app alone, does not make a hospital digital.
The Problem of Digital in Healthcare
In the recent Spring 2024 Budget the UK government announced that it is to make an 'extra investment' of £3.4Bn in NHS "digitisation", this is yet another, in a long line of significant investments UK governments have made in Health IT over the years.
Digitisation, being the process whereby a hospital, or health organisation automates the full end-to-end of its operational, including business and clinical processes as far as they can. It’s this automation that forms the core operational IT capability or ‘backbone’,
that is the essential pre-requisite, or preliminary enabler for a hospital, or health organisation to even become digital. As we said previously, it's very important to remember that Digitisation, this automation of the hospitals end-to-end processes and operation is the
'essential pre-requisite for a hospital to even be ready to play in this new digital, or technological era'.
However, despite these investments, UK Healthcare is still not digital, at least not in the truest sense of this word, and is yet to transform. It's important to recognise that the sector is now extremely late in completing this preliminary digitisation, especially as compared to other sectors of the economy, with the serious risk that it could be left behind, and unable ever to really catch up.
The reasons are manifold, and possibly need to be explored in a separate post/ report. I only mention here to point out, that if we don't act quickly, and moreover do something differently to what we've always done, then we are only going to continue to perpetuate, or see more of the same result, with the result that the health sector, could be left permanently on the backfoot technologically.
‘Re-thinking’ Healthcare
With all of this in mind, let’s now start to think about how we best digitally evolve the hospitalisation paradigm into the current, fourth industrial revolution/ era to now build a truly twenty-first century hospital, delivering high-standards, and quality of value-based, digitally-enabled care, founded on patient trust, and delivering compelling treatment experience, and convenience to patients.
With regards to evolving the hospitalisation treatment model into the patient's home specifically, what are some of the key enablers, trends and or requirements, at high level, from both technical and clinical perspectives that are available to us? We are going to examine these technological trends and enablers in this report. We'll focus more on examining the technological enablers, and also look at some ‘unusual’ issues from the perspectives of staff engagement that could be contributing to the slowness of the sector to transform. We'll conclude by going on to look at some of the considerations and actions, the Health CIO should now ideally have already thought about, and or be in the process of implementing, or might want to start moving forwards in their hospitals/ organisations if they've not already started to do so, in order to prepare their hospitals for these coming developments.
Key Enablers & Requirements
The enablers, that will power the new hospitalization paradigm, particularly within the home-care setting fall roughly into 2 camps or capabilities, the first being perhaps the most obvious, namely: the clinical 'technological enablers', the Telemedical devices and clinical-IT or EHR-type applications, that would logically be needed to support the patient’s treatment remotely, within the home. However, there is another secondary people-, patient-focused enabler, a ‘translation' if you will, that's also needed to transition the delivery of safe, compliant, effective, evidence-based acute care from the hospital to the home- and or community-care setting potentially also, and it's this 'translation', or transition, that we are calling, ‘The Cyber-physical Transformation':
The ‘Cyber-Physical/patient’ Transformation.
This transformation broadly comprises the governance, protocols, standards, and considerations for patient treatment, that are ideally needed to maintain patient trust, and now transition safe, compliant patient-centred care, particularly for some of the more complex or acute conditions, that have traditionally only ever been treated, solely within the hospital/ acute-care setting to date, to now be treated safely within the patient's home.
‘The Imagination Deficit’
So, what then are we saying is the problem? Why has healthcare still not transformed to date? Digital presents us with an opportunity to 're-imagine' healthcare as we’ve always said, so now into the scope of technological implementation comes distinctly human qualities like creativity, empathy and curiosity. Infact, we noted that Deloitte in their report on Human Capital Trends this year (2024), identified what they called ‘an imagination deficit’ as a hindrance to technological advancement, and growth, and thus in a real sense digital transformation, stating that:
"Technological disruption is outpacing the capacity of many workers and thus organizations to imagine new ways of working with and getting the best out of the new technologies," - Deloitte
Could this also be said to be having an impact in healthcare? Though in the case of healthcare, the reasons are also likely compounded by other factors, and perhaps isn't also helped by the flatter more matrix, management and organisational structures. which are a unique feature of Healthcare management, where responsibility, and accountability is spread sometimes almost equally across a broader spectrum of stakeholders, including executives, managers, governance, clinical leads, who all need to approve and or be consulted, through a range of boards, and or documented procedures.
However, Deloitte advocated in their report, that organisations may have to work to inculcate more of a culture of experimentation, and even ‘play’, creating digital safe places or ‘playgrounds’. were staff/ teams can be brought together and engaged to experiment, or 'play' with various scenarios and explore the resulting outcomes, as a way to facilitate greater understanding, and build their creativity.
They cited this particularly in relation to the ability of staff to capitalise on their access to data. Though it has been said that:
'Digital is a journey, not a destination'
with this in mind, could this be said to also have more wide-reaching implications for the digital journey the UK Health sector now finds itself embarked upon?
This may be an additional tool for the Health CIO to add to his strategy for staff engagement, and future digital deployment also, and if so, will create a need for the hospital data team to take an ever more active role in digital deployments, providing staff project teams, and managers with data workshops, access and support around ‘data sandpits’.
Creative Intelligence & The Digital Mindset
Deloitte went on to cite this as more an issue of the need to adjust mindset, to now give staff the psychological safety to experiment, collaborate, and explore. Although, it should be remembered that the previous iteration of the ’Fail-forward’ mindset, necessary to embed the culture of small, iterative experiments that are a key feature of digital, never did really get fully embedded, or take serious hold in the collective mindset of the health sector generally...
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