Driving Transformation with a Digitally Empowered Workforce

The next stage of digital transformation in healthcare across the APAC region will depend on a fully engaged workforce – and that means leveraging the short-term benefits of accelerated change during the pandemic to innovate and drive new processes.

Converting the experiences and learnings gained during the COVID-19 pandemic into everyday practice must be central to the next phase of digital transformation in healthcare if providers are to deliver the benefits of innovative workflows and patient-centric care.

That was the main conclusion of a session focused on the digitally empowered workforce, held July 29 at the HIMSS APAC Health CIO Summit. Charles Alessi, MD, the Chief Clinical Officer at HIMSS, said that ultimately, digital transformation has to be about people – clinicians – and helping them to accept and engage with the changes that have taken place so rapidly during the pandemic.

“Getting clinicians to coalesce is a challenge for us all,” he acknowledged.

He added that while technology might be an enabler, the successful governance of digital transformation will require the workforce to collaborate in ways that clinicians – instinctively used to focusing on perfecting their own processes –  will find challenging.

“The pandemic has supercharged digital transformation globally,” he said.

Alessi suggested that what was previously a peripheral activity is now mainstream, affecting the entire workforce, including those who did not choose to embrace the changes and are still not necessarily enthusiastic about them.

Seize the Moment

“Now is the time to leverage automation to improve healthcare processes, but sensitively, taking the workforce with us and recognizing that we are still in the foothills of making it comfortable with the new world of digital health,” Alessi said.

Two case studies discussed during the session revealed the power of capturing progress achieved during the pandemic and using it as a foundation for a new phase of innovation.

Andrew Pearce, senior digital health strategist for HIMSS in Australia, offered the Hospital Authority (HA) of Hong Kong as a leading example of what excellence looks like in the APAC region when it comes to digital empowerment. HA is a statutory body established in 1990 responsible for managing Hong Kong’s public hospital services. It gained a 97% rating for Governance and Workforce on the HIMSS Digital Health Indicator, the highest globally to date – but is aiming to do even better.

“For us, a digitally-enabled workforce is a fundamental component of a digital health ecosystem and it requires a governance focus,” Pearce said.

He explained how the HA’s strengths had been demonstrated on four fronts:

• Digital strategy informed by automated, real-time program-level outcomes
• Data privacy and regulation, security, and flexible working policies to support the adoption and scalability of innovation
• Accountability frameworks for the 84,000-person workforce that support person-centric care across the HA’s 43 hospitals and 122 specialist and general outpatient clinics
• Well-developed population quality and safety outcomes, transparent governance decisions and clear accountabilities for all stakeholders

Collaborate to Innovate

The statutory body is now looking at further areas for improvement. These include:

• Better reporting of patient outcomes to advance care delivery
• Tracking and analysis of the impact of social determinants of health with the aim of personalizing care delivery programs
• Integration of social determinants in health data
• Risk management that considers automation bias and health equity in access to care
• Improving how staff are informed and enabled to work in this evolving environment

Alessi noted this example showed the value of healthcare professionals working in concert.

“In the realm of clinical governance, everyone has to agree on a process,” he said. “In a way, clinicians have to start thinking about doing things ‘wrong.’ Stop associating governance with a level of dilution, because you aren’t doing things as perfectly as you would if you were doing them on your own.”

Gareth Sherlock, Chief Information Officer at Cleveland Clinic London, said governance is one of the clinical success factors for the facility, which just opened its doors and will be joined by a new 184-bed hospital in 2022. He added that the integration of technology into the clinical experience is essential, but building products is not useful if caregivers do not know how to use them.

“Cleveland is really proud of the digital innovations that we’re bringing to the market in London,” he said, “but unlocking the value of all the equipment we’re bringing as well as the 80 applications we’ll deliver requires that our caregivers are trained to use them – and this is a challenge across the industry.”

Sherlock explained that many of the experiences the organization gained at its Abu Dhabi clinic have informed the digital innovations that will be used in London. Some examples include:

• A patient portal that allows patients to manage their appointments, check-ins, prescriptions and even hospital-stay meals, as well as giving caregivers mobile access to records and lab results
• Dictation tools and virtual desktops for physicians and nurses
• Point-of-care devices integrated with the EMR system to improve workflow and patient safety
• Enterprise analytics to harness data and quantify performance across all clinical domains in order to support continuous improvement

Sherlock said COVID-19 has brought the issue of preparing the workforce for a digital future – identified in the UK by the 2019 Topol Report – into sharper focus. This has been particularly true in relation to the advancement of telehealth and the growth of remote working during the pandemic. Significant lessons have been learned on both fronts.

“Cleveland had the capacity for telehealth before, but COVID-19 has accelerated and normalized it,” he said.

Globally, pre-pandemic, just 1% of the organization’s consultations were remote. They now account for 27%.

The organization’s rapid transformation has included the systemization of consultations, the development of a patient monitoring tool to improve the customer and clinician experience, and a joint venture with Amwell to develop a global second opinions service.

The Power to Change

“This is about leveraging COVID-induced changes to drive innovation,” said Sherlock. “New ways of caring for patients will also require new ways of working. During COVID-19, a big trend shifted to remote working – most of our staff worked remotely – but they are gradually returning willingly because we have always put their safety first, always been transparent in our communication, and we have a strong culture that drives caregiver retention.”

With retention likely to be a key indicator of digital transformation success, Alessi was in no doubt that this is where providers must concentrate their efforts.

“If [transformation] was only about wires and boxes, we’d have done an awful lot more of it successfully, and we haven’t.” he said. “Our combined advice and counsel is to spend more of your time engaging people than perhaps you have in the past. The engagement of individuals is of fundamental importance because that’s what will make the big breakthrough.”