Digital health transformation – Part 1 – Introduction

CEOs must lead digital health transformation: it takes a leader before it takes a village

Michael Walsh and Sabrina Walsh, Powerhouse Partners

Digital health transformations are notoriously difficult. They often take longer, cost more, are messier and can deliver fewer benefits than planned. Sometimes they fail completely and can ruin or damage reputations and public confidence. This is despite decades of experience across the world, mature technologies and robust planning and delivery methodologies. However, when done well, digital health transformations can revolutionise healthcare services, deliver improved health outcomes, shorter treatment times, less errors, improved continuity and timeliness of care and more satisfaction for patients and clinicians.

Why is it that things often go wrong … and what can CEOs do to start and finish successfully?

There is extensive literature, resources and methodologies to guide digital health transformation, all of which are essential for a successful digital health transformation, but there is little practical guidance for CEOs that combines both the hard and soft aspects of digital transformation across the transformation lifecycle.

In this set of papers we share our thoughts based on our personal experience over the past 20+ years. Our insights come from our health service, technology and digital transformation leadership roles, along with our background as psychologists.

What is digital transformation?

Transformation has become a buzz word that is in danger of losing meaning. To keep it simple we define transformation as planned, significant and sustained change to how an organisation operates and the way people do their jobs.

The information technology research and advisory company, Gartner, broadly defines digital as social, mobile and cloud. Digital is not just a new term for electronic. Digital changes can disrupt industries and is no longer just an enabler – it can now drive new business models (e.g. Uber and Telehealth). Digital transformation uses digital technologies to change the way health is delivered with real time access to information anywhere at the heart of this.
The health industry is in the early stages of digital disruption and in our experience may not be sufficiently prepared.

Not every technology implementation is transformative. For example, technology infrastructure or like-for-like replacements may bring no improvements or only slight improvements that are not transformational.
Every technology investment however, should be considered for its transformative potential.

Digital health initiatives that significantly change (or should change) the way health organisations operate and deliver services (i.e. that are transformative) include:

  1. implementing a hospital wide or multi-hospital electronic medical/health record system
  2. implementing healthcare practice applications that provide a completely digital and holistic view of a patient
  3. implementing systems that provide seamless and mobile health record access for clinicians and patients including appointment scheduling, telehealth capability, medications management and diagnostic reporting, and
  4. establishing real-time data analytics capability to enhance healthcare outcomes, reduce errors, increase efficiency, provide decision support and take advantage of emerging artificial intelligence developments.

Digital transformation is a leadership challenge

Transformation is about change and change is about people. The usual digital transformation lifecycle goes something like strategy; governance; investment and implementation planning; and program and project delivery. This assumes that organisational change will be effectively managed as part of the transformation program. In our experience, this is way too late.

Often, CEOs and senior executives are over-confident in program level change management and don’t see an active role for themselves (unless they are the program sponsor and feel they have sufficient digital content knowledge).

The leadership work starts before the beginning, i.e. very early engagement gives people the opportunity to be meaningfully involved with the ’why’ and ‘what’, before the ‘how’ is decided. This is especially true in health organisations which have a highly skilled and intelligent workforce, strong cultures, and professional tribes that respond best to inclusive leadership approaches.

Digital transformations also require precious time from a CEO’s demanding schedule. CEO’s need to investing significant time in a digital transformation to be able to listen, discuss, clarify and challenge. It is engagement time that allows a CEO to arrive at a transformation narrative that reflects the voice of the health service, the voice of the consumers and the needs of the system.

Standard governance frameworks spell out key roles such as Program Sponsor (or Senior Responsible Owner) but they do not address the role of the CEO. At the same time, anyone who has been through a digital transformation will tell you that ‘support from the top’ is absolutely essential. The challenge for many CEOs and senior executives in health is that they have to ‘learn on the job’ when it comes to leading digital health transformation. What exactly is the CEO role in building trust and leading digital transformation across the transformation phases (governance, strategy, planning and delivery)?

Building trust is the key leadership challenge. It starts before the other phases and continues throughout the transformation. In the next five papers, we explore the role of the CEO in building trust and the key leadership challenges and questions for CEOs across the phases of the digital transformation journey.