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Slack Is Needed If The Digital Transformation Of Healthcare Is To Succeed

At the start of the Covid pandemic, Microsoft’s Satya Nadella famously remarked that we had seen 2 years’ worth of digital transformation in 2 months, as the crisis presented just the kind of “burning platform” that is so often said to be vital to triggering meaningful change.

Nowhere has this been more so than in healthcare, where digital technologies were used in a wide range of ways, from treating Covid and non-Covid patients alike under social distancing measures, to utilizing m-health for contact tracing and diagnosis of the virus. We also saw regulations that would ordinarily restrict the speed of rollout either adapted or suspended to produce digital transformation at a speed and scale never seen before.

While investments in areas such as telehealth and data analytics were underway before the pandemic, necessity very much became the mother of invention as providers scrabbled to maintain business as usual while also grappling with the wave of demand provoked by the pandemic itself.

Popular changes

A recent report from Dutch consultancy firm Mobiquity shows that the public is broadly supportive of these changes. For instance, a third of UK patients said that they now prefer m-health apps to in-person consultations due to the convenience they provide and the usability they offer.

“The COVID-19 pandemic has accelerated digital transformation in healthcare,” Teun Schutte, Managing Consultant, Mobiquity, says. “It has provided a catalyst for patients and healthcare professionals to adopt digital health solutions, such as mobile healthcare applications, in the context of social distancing, mask-wearing and stay-at-home guidance.”

While these things are indeed valuable, and one would hope that perhaps the forced pace of change will lead providers to streamline the way innovation is done, it is also perhaps fair to say that most of the “digital transformation” we’ve seen around the world, and certainly in healthcare, has been of the type that allowed for business as usual to be maintained as much as possible.

Telehealth consultations were introduced because face-to-face consultations were no longer feasible, for instance. It’s noticeable that a survey from Dell last year found that despite the significant investment in digital technologies across the economy, relatively little was invested in groundbreaking technologies such as AI and robotics.

Limited transformation

For instance, a recent survey from British Telecom of the UK’s National Health Service showed that just 18% of health organizations were using mobile health apps, with just 40% using online booking systems. These are fairly straightforward technologies that have been around for some time and certainly a long way from the data-driven transformation of health with the accompanying exploitation of artificial intelligence to drive meaningful changes to the ways in which healthcare is provided that were predicted before the pandemic.

If healthcare is to truly transform rather than “merely” digitize existing practices, then it needs to grapple with such macro-trends as the aging population, the need for wellness and preventative care, health inequalities, and so on, all while fighting the inevitable backlog of treatments caused by the pandemic and state finances that are in a parlous state.

Perhaps the most valuable thing healthcare providers could benefit from if they want to make meaningful changes is time. For instance, research from Aberdeen Business School found that spare time in people’s schedules was vital for them to innovate.

“At the end of each interview I asked the interviewees what they would do first to encourage innovation in their organization if they were suddenly omnipotent. By far the most common answer was time.

But respondents often qualified this – they didn’t want more of the same kind of time, they wanted more unstructured time that did not have specific outputs or procedures attached to it. The managing director put this very well when she yearned for ‘time to play, time to gaze out of the window, time to let things settle, time to read and react,” the author writes.

A similar finding emerged in a study from the Rotman School of Management, which showed that slack was vital for performing the often mundane, yet crucial tasks that underpin successful innovation.

“Slack time does something more than what we thought,” the authors say. “You need a creative idea for sure, but you also need to tell people about it and you need to put some effort into raising money. Slack time may give you the opportunity to do those mundane, execution-oriented tasks.”

Burned out

All of which does not bode well given that a recent report from the House of Commons Health and Social Care Committee illustrated the extent of burnout among staff in the NHS.

The paper revealed that nearly half of healthcare workers reported feeling unwell as a result of work-related stress during the pandemic, with one in three trainee doctors reporting burnout in a recent survey from the General Medical Council.

Indeed, research from the University of Hamburg found that innovation can actually contribute towards burnout, especially if workplaces demand that existing productivity is maintained at the same time as new technologies and processes are introduced, which is often the case in healthcare systems that give the feel of running in order to stand still at the best of times.

Indeed, this was illustrated by research from Brown University into the introduction of electronic medical records.  The paper found that the rollout of electronic medical records has increased stress and burnout among doctors.

“You don’t want your doctor to be burned out or frustrated by the technology that stands between you and them,” the researchers explain. “In this paper, we show that EHR stress is associated with burnout, even after controlling for a lot of different demographic and practice characteristics. Quantitatively, physicians who have identified these stressors are more likely to be burned out than physicians who haven’t.”

Time was a common concern, with doctors who felt they had insufficient time to do their documentation at work suffering burnout at 2.8 times the rate of their peers who didn’t suffer in the same way. This lack of time was far and away the most serious cause of burnout found by the data.

Responding to change

If that sounds rather bleak, it is undoubtedly extremely difficult. A glimmer of hope comes via research from George Mason University, which looked at the impact of autonomy and empowerment of medical staff on their ability to change successfully and their levels of burnout.

The researchers found that when healthcare staff have the ability to respond to change they experienced lower levels of burnout. This was especially so when their workplace provided strong teamwork, communication, and overall leadership support.

“We know that health care work environments and job demands have a profound effect on the health and well-being of those delivering care, and they may even influence the quality of health care received by patients,” the researchers say. “Especially as our health care professionals and systems are being pushed to the limit in response to the COVID-19 pandemic, it is imperative that we are more aware of the influences of the work environment and job demands on health care professionals’ health and well-being.”

Given the demands placed on healthcare staff show little sign of abating, it is perhaps worth managers keeping this in mind should they wish to also continue the more meaningful transformation of the sector in the post-Covid period.

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