The perfect vision versus the realities of IT
This scenario has been experienced by almost every medical facility. The healthcare manager plans to expand or replace IT software. The goal is to improve efficiency, healthcare delivery, and quality of care, as well as automate administrative tasks. Ambitions at the executive level immediately run into resistance from employees: They will have to learn the new application again. This means additional responsibilities even though they are overburdened.
While the employees can still be convinced, the plans ultimately crash against the skeptical attitude of the IT department. Its arguments are also strong: "We've only just managed to stabilize the operation of our software, so it's better not to touch the complex IT infrastructure if it's working steadily." No wonder, since most of the technical challenges fall on the IT staff, while the manager expects his plans to be implemented. Ultimately, an ambitious project is reduced to a compromise far from the original idea.
Smooth cooperation between medical, IT, and administrative departments
The 2019 study "Causes of conflict between clinical and administrative staff in hospitals" shows that clashes between administrative and clinical staff are most often rooted in mismanagement, ineffective internal communication systems, and resulting misperceptions. The same is true of "management-IT department" conflicts.
Many medical facilities continue the model that worked back when IT was limited to billing applications. The problem is that they have nothing to do with digitalization, which today is a strategic element of growth. Unless the facility has made internal organizational changes, conflict will be inevitable.
One approach to connecting IT and medical spheres is to establish the role of Chief Digital Officer (CDO), Chief Digital Transformation Officer (CDTO), Chief Information Officer (CIO), or the Directorate's Information Technology Officer. You name it. However, there is no "one-fits-all" solution. It all depends on the size of the facility and the management model. A person in this position – or a regular employee with this competence – orchestrates digitalization, balancing the interests of the board of directors, employees, IT specialists, IT suppliers, and patients. The task is to manage long-term digital development in such a way as to support the model and goals (business, quality, cost) of the entity. Ideally, the position should be held by a trusted person, or even better, a doctor or nurse with technical competence and communication skills. However, it must be a person who understands that the implementation of digital innovations is a continuous process; someone who can carefully evaluate the rationale for implementing the innovation and its impact on the medical facility, rather than individual systems and applications.
A grand plan for the future
Going back to the earlier conflict scenario: Instead of delegating the task of new system implementation to the IT department, the manager delegates this type of task to the DTO. This one is responsible for creating a strategy and communicating it to employees. Such a plan should be a roadmap broken down into the levels of digital maturity that the facility wants to achieve in the coming years.
There is little room for spontaneous implementations, although these will happen when the healthcare authorities impose new, unexpected duties. The plan is regularly developed with the IT department and communicated to employees so that change is not surprising but continuous.
According to our interviews, digitization leaders within healthcare organizations have three priority tasks: strategy development, IT planning and project management, and communication. Communication will sometimes be the most important – the challenge is to create or strengthen a culture of innovation, experimentation, openness, and respecting employees' existing responsibilities and workloads. It requires a lot of empathy and dialogue.
However, delegating strategy outside the IT department does not mean reducing its role to technical tasks but making the best use of IT competencies. The person in the position of CDO takes over strategic tasks but ensures that IT projects are well-planned and do not burden the IT department.
