Digital healthcare transformation starts with accepting your legacy

The digital world across all industries is buzzing about digital transformation and how it will change and shape our future. I love the term and have high hopes for the future. On Google Trends, there is an increase in the search interest for the terms “digital transformation” by a factor of 10 in the last 5 years. But what is behind this glittery and intriguing concept — you know, in real life?

IDC defines digital transformation as “the continuous process by which enterprises adapt to or drive disruptive changes in their customers and markets (external ecosystem) by leveraging digital competencies to create new business models, products, and services.” So digital transformation is about disruptive changes — not the incremental ones called business process innovation. Small changes and innovations are what we try to achieve, when we embed methodologies such as Lean. Disruptive, on the other hand, means obliterating and redesigning from scratch. This disruptive method seems very alluring, and on a strategic and conceptual level does represent a remarkable vision. But digital healthcare transformation engagements will or should introduce at least two questions that all hospital executives, regional authorities or even national governments should ask their IT vendors:

  1. How is digital transformation accomplished beyond the innovation lab and PowerPoint? How do we go from strategy to actual roadmaps of change, where the business strategy, IT investments, and implementation roadmaps are perfectly aligned to deliver these new disruptive business models, processes and interactions with patients or consumers?
  2. What about our current architecture and the investments already made? The hospital I was employed at for 13 years had close to 100 core applications and an additional 1,500 secondary (or specific applications with a very focused installed base and user group). How do we adopt disruption and a complete redesign, when the actual IT architecture landscape doesn’t support that very well?

In the real life of a hospital’s chief information officer (CIO), IT operations, support and projects covering the primary 50 applications (electronic health records, laboratory, radiology, supply chain, etc.) will take most of the resources and time. Disruptive changes are therefore difficult to implement, when also combined with the fact that healthcare IT is about the life and death of patients — (patient security and privacy constitute a No. 1 challenge in healthcare). Therefore, small incremental innovations seem to be the way forward for most healthcare organizations, which — on the other hand — are often challenged by lack of enterprise adoption and scalability.

The short answer to the questions above is to embrace your legacy, whether it is legacy processes, business models, capabilities, knowledge or IT. All must be regarded as interconnected and creating that picture of your enterprise architecture, which is the first important step in any digital transformation initiative.

Only when you know your current situation (the “as-is”), can you plan ahead (for the “to-be”) with end-to-end solutions. That’s why it will be vital to approach the digital transformation as an enterprise-wide endeavor, rather than as a series of small innovations and projects. Innovations must fit your organizational strategy; only then will it be possible to deliver something truly new, innovative and disruptive by applying digital capabilities in large scale. The digital healthcare vision and strategy are the easy parts; it’s the execution that will pose a challenge.

As a healthcare CIO, you should:

  1. Transform your IT planning from reactive to proactive, by aligning the business strategy with your IT strategy, and create goals and roadmaps for future changes and investments.
  2. Expand your enterprise architect (EA) capabilities to map, plan and monitor your digital landscape. Ask yourself what kind of healthcare you would like to deliver in the future, and align that with your future digital landscape.
  3. Engage with IT service providers that have end-to-end capabilities and a strong healthcare presence and knowledge.
  4. Apply innovative technologies as pilot programs or through innovation laboratories, but plan from the start how to scale and adopt these throughout the enterprise. New technologies should be considered in relationship to your existing architecture, to understand where and how they fit in.
  5. Adopt collaboration technologies such as integration and data orchestration platforms and other data managements tools, which will increase the availability of your current data, leverage the investments you’ve already made in IT, increase data-sharing and interoperability capabilities, and enable adoption of new business models such as population health management, predictive analytics and data-driven decision support.

A global problem for most healthcare providers has been to scale innovations and deploy them enterprise-wide. Innovations are often small, very focused and end up delivering great value for very few people. That is why digital healthcare innovation and transformation strategies and initiatives must be regarded as key elements in the wider business strategy. Alignment between business and digital initiatives has never been more important. Innovate, plan and execute with that in mind.



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