In theory, digital technology offers new ways to work better, faster and cheaper. It should improve outcomes and free up staff to be more creative and productive. Yet, too often digitalisation wastes money and fails to achieve its main goals. In many cases, it isn’t the technology that is at fault, but lack of communications and poor management.
Consider healthcare. ‘The attrition rate of nurses is unbelievably high at the global level,’ says Kristina Mikkonen, researcher and doctor in health sciences at the Research Unit of Nursing Science and Health Management at the University of Oulu’s Faculty of Medicine in Oulu, Finland. ‘Digitalisation can be an excellent way of resolving this problem.’
Co-design is key
One initial communications problem lies in designing and selecting the new technology. People go into medicine because they’re passionate about caring for people, not technology. But those developing the technology often ‘haven’t functioned as clinicians or have experience working in hospitals themselves,’ says Danielle McGeary, vice president of health-care technology management for AAMI, which promotes safety in health technology.
‘They often do not have an in-depth understanding of the overall environment of care and clinical workflow,’ she says. ‘The successful integration of technology takes coordination between many different clinical and support services such as the pharmacy, phlebotomy, IT, healthcare technology management, nursing, respiratory therapy, etc.’
In some cases, technology suppliers jealously guard their secrets, and don’t fully involve clinical staff in developing technology, Dr Mikkonen notes. As a result, high-tech equipment offers new capabilities but its size or shape prevents it from being located where it is most needed. ‘It’s important to get people to understand what is needed to help clinicians provide the care and then build it, instead of building it and shoehorning it into care,’ says Jim Piepenbrink, deputy executive director of the .
The administrators who purchase the equipment might not know all the questions to ask, and vendors, not being asked specifically, might not point out, for example, that an interface will be needed to connect the new technology to the existing IT network, McGeary points out. Devices that connect via wi-fi need reliable service, “otherwise the system collapses and nurses will need to do it manually anyway,” Dr Mikkonen adds.
‘Rule Number One of digital transformation: it should never increase the workload—no additional steps, no extra time, and no long training.’
Rule Number One of digital transformation: it should never increase the workload—no additional steps, no extra time, and no long training. ‘There’s an overload issue for those who are supposed to adopt these digital applications,’ Piepenbrink says. ‘How can you take all this in and make sense of it?’ For example, while capturing data and creating algorithms that predict when patients need help, organisations also need to think about appropriate staffing. The technology team might think it’s simple, but senior management needs to evaluate how it impacts health professionals’ time. New technology might require a new staff position as a human interface. ‘Someone needs to have the bandwidth do look at it and analyse it. The doctor has to take care of the patient, not chug through a ton of data.’
Any new technology requires some investment in learning, but training might be too compressed, with little time for a refresher. ‘The knowledge transfer is problematic with the introduction of digital integration,’ Piepenbrink says. ‘The HTM [health technology management] professionals and IT people should be at the table to assist and guide how to handle the orientation and help assess the competency along with the clinicians who will use it.’
Training little and often
Frequent but short training sessions spread over time can be more effective than one long session full of new processes and jargon. ‘Before introducing new technologies in clinical practice, education should be prioritised,’ Dr Mikkonen advises. ‘Once attitudes are built, they are very difficult to break.’
Training needs ‘baby steps’ while emphasising how the new technology will reduce workload. ‘Regular education at a frequent level and regular technology usage can improve healthcare professionals’ competence,’ she says.
Employees also need to undergo post-training assessment, which might increase their resistance to digital technology unless undertaken in a collegial, supportive environment. Refresher courses after 30 or 60 days are helpful, when staff have experienced the new technology and have specific questions.
Companies undergoing any form of digital transformation – not just in the health sector – should bear in mind the following points:
- New digital technology must always reduce workloads
- Assess training of new technology
- Repeat training after a break of weeks or months
- Decide early whether a human or other interface will be needed to smooth the transition