What Is Holding Healthcare Back From Digital Transformation?

WHAT IS DIGITAL TRANSFORMATION?

According to an article published in NEJM Catalyst, digital transformation "rests on the effective adoption of information technology to improve an organization's performance and competitive position."

A Harvard Business Review article defined digital transformation as "using digital technologies to create or modify business processes, culture, and customer experiences."

"Digital transformation means so many things to so many people in so many different industries," Laura Kidd, senior account executive at Core BTS, explained in an interview with HealthITSecurity.

"For healthcare, it is the ability to serve patients better digitally, where they are."

Digital transformation involves the adoption of technologies with the goal of improving workflows, efficiency, and patient care. EHRs, telehealth solutions, and cloud security technologies all contribute to digital transformation.

However, a 2020 study by Boston Consulting Group revealed that 70 percent of digital transformation projects fail to meet their goals without significant setbacks and suboptimal results.

In NEJM Catalyst, experts proposed three factors that contribute to successful digital transformation. The first was "defining the transformation before choosing the appropriate technologies, rather than allowing a given technology to dictate the nature and structure of the transformation."

The second factor involved evolving the business model to enable new capabilities, and the third was developing strong organizational transformation and improving management competency.

The healthcare industry is ripe for change, but several challenges prevent the sector from pulling ahead. Even so, with cloud adoption in healthcare at an all-time high and continuing advancements in digital health, the industry is taking meaningful steps toward digital transformation.

At an organizational level, leaders should understand the common barriers to digital transformation and implement new technologies with security, privacy, and patient safety as their top priorities.

BARRIERS TO DIGITAL TRANSFORMATION IN HEALTHCARE

"Despite the medical profession's embrace of all kinds of advanced technologies in other categories, from molecular medicine to robotic surgery, health care lags behind many other industries in its adoption of many digital innovations," the NEJM Catalyst article stated.

"Driven by multiple factors, including the explosion of telehealth to provide care during the Covid-19 pandemic, the health care industry has reached a point where it must achieve greater digital transformation and must do so by leveraging both new and existing technologies."

Digital transformation has touched every industry and has transformed healthcare in many ways. However, high stakes and fear of modernization may be preventing the industry from fully embracing digital transformation.

"There is a significant shortage of people to do the work," Kidd pointed out, referring to the ongoing cybersecurity and IT workforce shortage.

"You have your cyber folks trying to work both in the cloud and on-prem, managing multiple different applications with different needs. So, the room for error there is significant, not to mention the risk for burnout as well. It is an extremely stressful position to be in."

Every new internet-connected technology has cybersecurity implications. That means that an organization's cybersecurity workforce must be available to assist with adoption and implementation to ensure the safety of patient data.

A survey conducted by (ISC)² found that while the cybersecurity workforce gap narrowed for the second consecutive year, the global workforce still must grow by 65 percent to defend critical assets effectively. The workforce shortage could cause remaining employees to be stretched too thin, allowing critical vulnerabilities and suspicious network activity to fly under the radar.

Along with a shortage of people to commit to digital transformation and implementation, healthcare also relies heavily on legacy systems to perform critical workloads. Legacy medical devices pose security concerns because they are difficult to patch and keep track of due to their portability. In addition, organizations may not want to risk updating these devices when they are still successfully performing critical services.

"Healthcare organizations have all these different applications and clinical needs that they must meet. You might have this one application that saves babies' lives and it's on seven computers and you don't know if it's going to work on the latest version of Windows," Kidd pointed out.

"So, there is just a lot of fear in making those big jumps to modernize."

Healthcare is also bound to HIPAA and other industry-specific regulations that may make digital transformation more of a challenge. Organizations must consider HIPAA's privacy and security requirements while implementing and using any new technology.

Whether dealing with EHRs or AI-driven analytics tools, organizations must prioritize the privacy and security of protected health information (PHI). These new technologies may also warrant additional staff training and security protocols, making the process more burdensome.

Healthcare faces unique challenges when it comes to digital transformation, but that does not mean that the industry is navigating uncharted territory. The sector can learn from the successes and failures of other industries to improve digital transformation efforts.

TIPS FOR ENABLING SECURE DIGITAL TRANSFORMATION

"How do you change when you don't have a thorough understanding of what's in your environment and how your users are interacting with technology?" Kidd remarked.

Learning from other industries can be a useful exercise in preparing for digital transformation, the NEJM Catalyst article suggested. Specifically, it can help organizations figure out what technologies are worth investing in to meet their business and patient care goals, rather than getting overwhelmed by the different options that could enable digital transformation.

For example, when Netflix emerged in 1997, its goal was to provide at-home entertainment by leveraging the internet for video rental services. But as technology advanced, Netflix pivoted to streaming content and shifted its strategic objectives to reflect new capabilities.

"How might a health system apply this principle in evaluating its digital options?" the article asked.

"Suppose its strategic objective is to become both a provider and an insurer to leverage this dual role to advance care quality and efficiency. Being both a provider and a payer changes a health system's economic equation. Because it is billing itself for the care it provides, any technology has to help it deliver both better care and lower cost."

Healthcare organizations can learn from Netflix and other companies that successfully transformed by asking themselves whether a specific technology can actually advance one or more of its goals. Implementing new technologies can be time-consuming, therefore choosing the right technologies is especially crucial for organizations that don't have time to waste.  

Boston Consulting Group found that companies with an integrated strategy and clear transformation goals flipped the digital transformation success rate from 30 percent to 80 percent.

Unfortunately, solving the cybersecurity workforce shortage and the sector's widespread reliance on legacy systems is not a problem that anyone can solve overnight. These barriers will likely persist, but that does not mean that secure digital transformation in healthcare is impossible.

Making calculated procurement decisions and leaning on technology to fill in the workforce gap can help reduce some of the burdens on the workforce and enable secure and rapid technological adoption.

For example, industry clouds may help to catalyze digital transformation. Industry clouds offer sector-specific cloud solutions that help organizations reinvent business processes and reduce redundancies.

"It means you enter the race with the best possible car and make modifications to prebuilt equipment with an expert crew, rather than building your car and team from scratch," a Deloitte report suggested.

"Such solutions are emerging in every industry and are continuously evolving to address new sector challenges and incorporate the latest digital capabilities."

Investing in cohesive solutions that enable automation can also reduce security and privacy concerns and free up workforce members to prioritize other advancements to their organization's security architecture.

Finally, to reduce the fear of modernization, Kidd suggested that organizations know when to partner with industry experts.

"There is no way for an organization to be able to transform on their own," Kidd emphasized.

"They need to partner effectively and seek people who can provide that guidance and build a roadmap to digital transformation—because mistakes can be costly."