The pilot approach rewards health services that are already digitally mature, which widens the digital divide.
Implementing pilot projects for digital health solutions in healthcare is hard.
There are myriad complex considerations that impact adoption, ranging from funding, incentivisation and motivation through to the digital literacy of patients and health providers. As a result, many projects, even those that show reasonable results, never make it beyond pilot stage. The “digital health pilot” is where many good ideas, implemented poorly, go to die.
And if implementing pilot programs for digital health solutions in healthcare is hard, then taking solutions from pilot project to systemic, large-scale adoption is harder still. Turning a successful pilot project into a widely adopted, sustainable, digitally enabled model of care is an art that few have truly achieved. The huge variety of current state infrastructure, digital literacy, clinical workflows and organisational cultures make implementation on a large scale extremely challenging.
One of the great risks in the “pilot” approach to driving adoption of digital health solutions is that it rewards health services which are already mature. Digital health maturity is a quantitative and qualitative measure of the extent to which a health organisation has already adopted, and is positioned to adopt, digitally enabled models of care in the future.
Therefore, organisations that are progressively minded and have had previous success are more likely to put their hand up to implement new digital health solutions. And whilst this is not inherently a bad thing, it risks exacerbating the “digital divide” between health services. The already mature become more mature. Those without digital confidence get left behind.
This is also a problem for patients. A growing digital divide between health services creates a postcode lottery. If you’re lucky to be in the catchment area of a digitally progressive health service then good for you. But what about those patients, particularly in regional and rural areas, who aren’t as lucky? It is imperative that digital health plays a key role in improving access and equity in healthcare. If we’re not careful, it can do the opposite.
So how do we lift the capability of all health services, whilst recognising that many are at different points on their digital health maturity journey?
The start of a more successful, repeatable approach to implementing digital health-related change begins with measurement. It’s important to understand what digital health technology and infrastructure is in place, and how it is being used. And beyond that, what do health services believe and understand about digital health and the role of data? What is their readiness for digital change? What gaps do they have in their digital literacy? What clinical leadership is in place to support and drive the change?
Only through a detailed understanding of these and other factors can we build resilient digital health change programs that cater for the wide range of needs at different points on the maturity spectrum.
Semantic Consulting has been working with health organisations for the past three years to develop and refine a methodology and tools for measuring digital health maturity in healthcare, with differing baselines across general practice, allied health, aged care and secondary/acute care. The purpose of these tools is not to reward those already doing well, or to punish those who are lagging behind. The aim is to support the systemic implementation of digitally-enabled models of care through a flexible change approach that can adapt to the specific needs of health services, depending on where they are at on the digital health maturity journey.
The results of measuring digital health maturity in this way have been fascinating. As the process has matured, the hypothesis that different health services need different things has been validated.
Results have shown that health organisations that are at the mature end of the spectrum are usually already motivated, and tend to have a focus on “how?” questions. “Explain how it works.” “Give me the quick reference guide.” “Give me some short training videos.” Contrast that with health organisations at the other end of the spectrum, who are usually more focused on the “why?” questions. “Why should I care about digital health?” “Why does high-quality data matter?” “Why is it my job to do this?”
The maturity assessment process gives us an increasingly scientific and repeatable basis on which to help all kinds of health organisations on their digital health maturity journey. Sometimes this has involved developing different communications and training materials for different health services implementing the same digital health solution, referred to as a digital health change toolkit. Sometimes it has involved advising health services that they’re not yet ready to implement a new digitally-enabled model of care, and that they should channel their energy into strengthening the foundations first.
Regardless of the outcome for individual health organisations, the conclusion is clear. Achieving the systemic adoption of digital health requires a more nuanced approach to change based on a deeper understanding of digital health maturity.
A more flexible approach would support greater success and sustainability in the systemic rollout of digital health, and ensure that digital health pilot programs don’t flounder when they move beyond the first set of (already mature) health organisations. In fact, maybe a greater quantitative understanding of digital health maturity will give us the confidence to pilot digital health solutions at less mature organisations, creating models of care that are more likely to work for the average health service.
Tim Blake is managing director at Semantic Consulting.
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