Digital health transformation – Part 2 – Trust

First build trust: A key role for the CEO in digital health transformations

Michael Walsh and Sabrina Walsh, Powerhouse Partners

Transforming health service delivery models, structures, roles, and business/clinical processes really does indeed take a village and early, lasting and strong leadership will make or break digital health transformations because transformation is about people, behaviours, and relationships.

We all know that transformations require people and organisations to change but our experience is that CEOs and Executives often under-estimate how critical trust is to program success and getting real value from the investment.

We recommend working on trust before governance, strategy, or business cases because trust takes time to build and transformation programs are by their very nature time-limited.
Trust doesn’t just happen: it builds up over time and takes effort to maintain. Despite extensive change management activities, there is rarely enough time in a transformation program for the series of interactions and discussions needed to build trust. Moreover, the early discussions should not be outsourced to ‘change managers’: leaders need to lead.

Trust at all levels of the organisation is critical to starting, delivering and completing a successful digital health transformational program. Without trust, people will struggle to be committed and stay the course of a digital transformation program.

Building trust is the first step because successfully undertaking a digital health transformation is very difficult and everyone in the organisation needs to be ready to work hard to make it happen. Trust needs to exist at all levels in the organisation, across all professional groups and in all work units participating in, or impacted by, the change.

The process of building trust across the organisation is as important as the trust itself. Open and exploratory discussions about digital health will allow issues and benefits to be explored freely and a common vision and narrative to be developed and owned by everyone in the organisation.

The healthcare objectives of the organisation are always the starting point for a digital health transformation discussion. The business needs must lead the digital health transformation activities. However, digital health enablers are increasingly becoming interlinked with business objectives and discussing and understanding these relationships is essential to developing trust and a commitment to change.

Building trust also allows senior executives, clinical staff and others to increase their knowledge of digital health without feeling they have to know everything and have all the answers from the beginning. Building the understanding of digital health and how it is relevant to the business is essential for a successful digital transformation.

The role of the CEO

It is rare to see CEOs fully engaged in digital transformation initiatives. In our experience this may be because they have an over-confidence in the organisation and the program team to manage risks, or they think they lack technical knowledge (this is not surprising because consultants and vendors use jargon and tend to bring technology choices to the fore way to early) and so feel comfortable delegating to executives with an interest in technology or to the technologists themselves.

CEOs are ultimately accountable for the success of the organisation including culture or ‘the way things are done around here’. This includes how transformation is done. By making sure building trust comes first, the CEO sets the bar.The health industry is in the early stages of digital disruption and in our experience may not be sufficiently prepared.

By putting trust first, the CEO involves the organisation in the ‘why’ well before the ‘what’. This is not about simply asking people what they want – effective consultation never starts with a blank slate. Rather, it is about engaging the organisation (especially the formal and informal opinion leaders) is a two-way conversation as a precursor to governance and strategy.

The CEO must commit sufficient time to this first phase and make an ongoing commitment to remain engaged along the way. CEO time is precious and prioritising time to a digital health transformation is both essential and a worthwhile investment for both the transformation and the cultural health of the organisation more generally.

The CEO does not need to have all the answers. CEOs have a vision for the future of the business and embed the digital transformation into the organisation’s healthcare objectives.

Some take-homes for the CEO:

  1. Understand digital transformation is fundamentally a people issue – your issue.
  2. Commit to the journey – if you don’t, why should anyone else?
  3. You are an expert in the organisation – you don’t need to be a technology expert.
  4. Build trust first – before governance and before strategy – and keep at it.
  5. See the process of building trust (genuine, two-way communication) as important as the trust and commitment itself.

You will know when you are reaching the end of the building trust phase because you will have a digital transformation narrative that you see people using throughout the organisation. You will also have a vision and people will be talking about when and how the change will happen, not if it will happen.

Building trust helps you identify the right leaders for the transformation and in the next paper we explore the role of Governance in successful digital transformation.