While the healthcare industry has made significant progress in adopting digital technologies in recent years, the industry as a whole is still, - and it may even come as a surprise to some within the industry to know-, not fundamentally digital.
"If a Health Trust or organisation doesn't have a clear vision as to how it will improve the 'lives', treatments and experiences of its patients, then it may implement some compelling apps, and some cutting edge technologies but it won't transform."
The Great Divide
With the world now perched on the cusp of the fourth industrial revolution this is particularly problematic, and means that the industry may not be best placed to fully realise, and thus optimise the benefits of the next wave of technical innovation which is being heralded as an era of 'exponential technology.' The industry at present, seems to be attempting to straddle an inter-generational divide, with firm roots in the past, previous, or twentieth century, with the current 'hospitalisation' model for patient treatment, including the organisational structures of the modern hospital, not having fundamentally changed in well over a hundred years. While Healthcare is certainly giving credence to introducing new technologies, it has been slower not only to transform, but to also evolve the necessary mindset and protocols to consistently and continuously 'innovate-by design'. When I say 'innovate-by-design' I'm referring to the business of the hospital doing digital in the trenches, so to speak, in terms of the various services and departments that comprise the hospital, innovating data and technology, (with the support of their IT Departments of course), as a standard part of their mode of operating. This is currently the missing link, and is where they ideally need to get to.
The risk now, is that if the industry continues to be slow to respond to the expectations of patients in the area of use of technology, then eventually, either other companies, such as the Google's or Amazon's of this world will come in, and 'disrupt' or start to commoditise the Health experience of their patients for them, or alternatively, patients will pre-empt, and do it for them, as happened in the case of diabetes, where patients who wanted real-time information, access to additional devices and services, and greater personal convenience to aid self-management of their conditions, began to explore, network and promote available diabetic innovations and technologies within their communities, eventually forcing the industry, and their doctors to adopt, and integrate these devices and mechanisms into the diabetic treatment pathway. However, Diabetes in terms of its adoption of digital has been the exception in the Healthcare sector, rather than the norm.
What must the industry, and indeed hospitals and individuals who work within the industry now do to start to close the gap, that has now begun to open up between the expectations of patients, and the reality of levels of digital adoption and IT innovation in Healthcare.
Again, in some quarters it could be said, that there is a split between reality and perception, with many inclined to believe that Healthcare has already gone 'digital' due to many Hospitals having introduced numerous apps. However introducing or implementing an app does not make a hospital or organisations digital, and in cases where the strategy is insufficiently planned, or is ill-conceived, it can ultimately have a reverse transformative effect, and be little more than a 'bolt-on', or appendage to a patient's treatment journey, which undesirably adds, as opposed to removes, additional complexity and overhead for the specialty or departments to then resource and manage.
Reality vs Perception
While some of the obvious reasons for this disparity between reality and perception of the current state of innovation within the industry are possibly well documented and known, some of the other causal factors remain either unacknowledged or are not widely recognised.
There are several reasons why the industry as a whole cannot yet be deemed to be fully digital, lets start by looking at the obvious reasons first, before going on to examine those causes that may perhaps be less obvious, or that may be said to be almost hidden in plain sight, for example.
"Technology changes quickly, organisational change much more slowly" George Westerman
In terms of the reasons which are largely agreed within the industry to be the more obvious, as to why we are still not fully digital as a industry, at high level, these distil into 6 broad reasons or categories of issues, namely Complexity & Fragmentation, Privacy & Security, Interoperability, Legacy Systems, Regulatory and Compliance, and Resistance to Change:
1. Complexity and Fragmentation:
The healthcare industry is complex and highly fragmented, with numerous stakeholders involved, including hospitals, clinics, the Integrated Care Systems, (ICS's), and government regulatory agencies, to name just a few. In the case of US Healthcare this is further added to by the insurance, and pharmaceutical companies, and more. Coordinating digital initiatives across these diverse entities and ensuring interoperability is proving challenging
2. Privacy, security, Regulatory and compliance concerns:
Healthcare data is highly sensitive and subject to strict privacy, as well as regulatory and compliance requirements, such as the Health Insurance Portability and Accountability Act
HIPAA) in the United States. As a result, healthcare providers must take extra precautions to ensure that patient data is not only protected from unauthorized access, but also adheres to the necessary regulatory requirements as well. This adds in an additional layer of complexity, making digital transformation all the more complex, time-consuming, and can slow down the adoption process.
3. Interoperability challenges:
Healthcare systems often use a variety of different technologies and software systems, which can make it difficult to share patient information and medical records across different organizations and platforms.
4. Legacy systems:
Many healthcare providers still rely on older, legacy systems that may not be compatible with newer digital technologies. Updating these systems can be expensive and time-consuming, especially for smaller healthcare organizations with limited resources.
5. Resistance to change:
Like any industry, healthcare has a culture and way of doing things that can be resistant to change. Some healthcare professionals may be hesitant to adopt new digital technologies, especially if they are not familiar with them or if they perceive them as being too complex or time-consuming.
Why Has The Health Industry Been Slow to Transform?
While they are many, even promising examples throughout the health sector of digital health initiatives that are currently underway, think telemedicine and remote patient monitoring for instance, that are becoming increasingly popular, and also Electronic Health Records (EHRs) which are steadily becoming more widely adopted. While these developments attest to healthcare providers becoming more comfortable with adoption and use of digital tools.
Innovating Digital in Hospitals in 'An Era of Exponential Technology'
The slowness of this sector to transform, and innovate, in comparison to other sectors of the economy is further compounded by the fact that healthcare technology is now on the cusp of taking it's next quantum leap, which is being heralded as an era of exponential technology, yet the industry as a whole technologically, is still in the process of building its basic core operational capability. This is the technology that was more foundational to enabling the previous technological era. Paradigm's latest report 'Why Healthcare Is Still Not Digital & What The Health CDO Can Do About It' also goes on to point out that this new technological shift will also bring with it a number of new hidden liabilities and risks for the (Health) CDO and Health organisations to manage, that have been hitherto unforeseen; and that furthermore the industry is essentially without clear direction as to how to navigate this shift, including legislatively at this time, in areas such as AI for example.
A 10 Step Action Plan for The Health CIO/ CDO.
This report concludes with a 10 Step Action Recovery Plan of practical things the Health CDO can now start to do in order to catch-up, face, and begin to address these challenges, in order to commence and successfully kick-off the journey that is digital for their Hospitals.
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