Will slow and steady win the race? Change in Healthcare

Unfortunately, it took a crisis of pandemic proportions to motivate a shift of our healthcare systems towards the digital age. Germany is pushing the digital transformation of the healthcare sector, driven by the COVID-19 pandemic and a general need for reform.

Under the pressure of COVID, a new era of digital transformation in the health sector has begun with patient data at its heart. In light of the recent medical, economical and sociological events, Germany has been able to quickly instate policies and government subsidies that we could have only dreamed of before. Measures that would traditionally have taken years to come to fruition are now accessible for many in the healthcare community. 

Germany, for instance, enacted the Digital Care Act (Digitale Versorgengesetz or DVG), which makes eligible health apps reimbursable. A new regulation, the Digitale-Gesundheitsanwendungen-Verordnung (DiGAV), allows regulators to place qualified health applications into a central directory.  And the aim of the investment program adopted under the Hospital Future Act (Krankenhauszukunftsgesetz or KHZG) is to improve the digital infrastructure of hospitals, particularly in relation to IT and cybersecurity.


Why was only an event such as COVID able to bring about much needed change? 


Telehealth is the distribution of health-related information and services via electronic information and telecommunication technologies and it saves time and money for patients as well as healthcare professionals. According to AmWell, an in-person doctor visit in the United States takes 121 minutes (including travel, waiting and admin) or an equivalent USD 43 worth of time on average, while a telehealth consultation lasts for about 15 minutes, equating to USD 5 worth of (patient's) time. It’s safe to say that modern economies worldwide are experiencing similar differences in cost and time requirements based on treatment modality. 

We probably weighed ourselves in a type of false sense of security in regards to the processes and systems in place in our medical establishments. Yes, administrators would always like to save or make more money while the same is true for patients and their time and resources. But, in a way, it seems that we had all come to a sort of unspoken agreement that it was maybe “good enough” and that we had loads more time to institute change sometime in the future. 

But, sometimes we don’t know what we have until we lose it. 

So when we lost the ability to spontaneously go to the doctor and the freedom to go to work or school despite a common cold, we quickly realized that we needed different and more effective methods to one,  treat people remotely, and two, manage patient flows more optimally in order to manage the onslaught of Coronavirus infected patients. The old way just wasn't going to cut it. 

We were definitely woken up out of our technological slumber by the Corona crisis and there was no more time to wait. 


Why, even when the government is pushing for change, are hospitals still notoriously slow at adopting it? 


Despite being around for decades, electronic medical records are largely the same today, supported by infrastructure that dates back some forty years. The industry is too fragmented for one disruption to transform things overnight. There are still too many variables in healthcare to provide a one-size-fits-all system. 

Having a patient visit a doctor or getting treatment often involves many people. Education, customer service, and other human aspects of our relationship with customers and patients must also be considered so that we can not only meet their current needs, but predict their future needs as well.

Implementing and enforcing healthcare reform involves many factors. Complex and slow-to-change policies are obvious ones, but environmental and technological factors also influence healthcare. Illness trends, doctor demographics, and technology also play key roles.


What are some of the specific challenges? 


In a fairly fragmented policy-making system, there are opportunities to introduce new ideas, reorganize priorities, soften rules, and introduce new complex rules and procedures. Yet reforms that depart from the status quo are severely limited.

A key challenge the healthcare sector faces as a result of the digital health revolution is compliance with complex laws like HIPAA and DSGVO - and it means extra work for the healthcare workers involved. This discourages them from becoming part of the digital health revolution. It’s also important to realize that we are not dealing with technological change for a factory or for a machine. Healthcare is still a branch based on human touch and on the human factor. In contrast to other branches of production, like the automotive and software industry, what is done in medical establishments is much less standardized. Every patient and provider is different, whether it is personally, physiologically, or socially. Unlike steel, patients and providers alike have agency that should be respected by the health care system.

And even when understanding and heeding this to the highest degree possible, more obstacles within hospitals remain, such as interdisciplinary and interdepartmental access to health data, lack of bidirectional data exchange, confusion over the implementation process, and fees that may prove to be prohibitive of introducing new technologies.


What role does leadership play? 


In healthcare, we must redefine what leadership looks like.

In truth, protecting and preserving is valued more than pushing and driving. Those in power in large healthcare organizations must figure out how to work with leaders whose drive for progress can act as a catalyst.

Often, we do not want to make the hard decisions. Managing performance aggressively or saying "no" aren't done nearly enough. Thanks to the healthcare industry, nice and compassionate people are attracted. Unfortunately, being a nice person doesn't necessarily prepare you for managing change and transformation in a complex industry, as making difficult decisions requires confidence and willingness. Conflict is essential to the progress of organizations. Healthcare organizations must address the obstacles that prevent them from doing things for patients that they know are right.

It is challenging and exhausting to promote change. In order to bring about change, managers need to challenge precedents and be persistent against established habits and norms. The manager must dedicate time in order to bring about that desired change. In order to succeed, managers need to know what values matter and focus on changing them, rather than responding to every random change request. It is imperative that responders and proactive actions are developed based on what is significant.

Developing new organizational structures and establishing a shared vision that focuses on authentic employees' output can assist leaders in assisting employees and other stakeholders in building effective teams. Such inspired and informed leadership is critical and essential for organizations to be successful.

For change to succeed, it is important to have a clear idea of where the change should go and to measure and monitor outcomes.


When to make your move?


As healthcare becomes more efficient, the use of new technology can be used to improve care coordination, add to information access for both patients and providers, and guarantee high-quality, safe, efficient, and cost-effective care.

Despite the delay in healthcare adopting technology, improvements are still occurring at a remarkable rate which eventually force the sector to embrace them.  Increasingly, empowered consumers and cost-conscious payers are demanding accountability from health care innovators. For instance, they require that technology innovators show cost-effectiveness and long-term safety, in addition to fulfilling the shorter-term efficacy and safety requirements of regulatory agencies.


Companies are far from helpless in the face of obstacles to health care innovation. A few simple steps can position hospitals to not only survive in these trying times, but to thrive.


Let’s not wait for things to get worse once more before we realize that actionable steps towards modernization, digitalization and automation need to be taken.

As medical technology evolves, understanding how and when to adopt these technologies is crucial. Making a move too early could mean that the infrastructure needed to support the innovation may not yet be in place. But, waiting too long could bear the risk of losing a competitive advantage.

In the modern world of healthcare technology, with new challenges rapidly arising every day, slow and steady unfortunately will not win you the race anymore.  


Roland Berger Trend Compendium 2050