China's healthcare and its digital revolution are being accelerated by Digital China and Healthy China policies. This major shift, coupled with digital transformation, are often plagued by challenges such as misalignment of current positioning, transformation leadership and digital readiness. This article examines these factors to better understand the effort.
Digital transformation is now one of the hottest buzzwords in China’s healthcare industry, owing to the twin engine, Digital China and Healthy China policy. The former advocates creating a new digital economy with emphasis on data and data-driven technology, while the latter rewrites the foundational logic, shifting from a treatment-centric to a health management centric perspective.
The vast increment in scope and hastening of tempo for healthcare organisations driven by these two policies has brought about a fundamental transformation in how medicine is practised and how healthcare services are delivered.
However, digital transformation is extremely challenging, and is of no difference for Chinese healthcareorganisations. One of the fundamental reasons is a misappropriate alignment of current positioning which ends up barking up the wrong tree. Hence this article summarises a couple of the key lessons learnt from recent digital transformation efforts to provide organisation leaders with a clearer perspective on alignment.
Due to various reasons and complex descriptions, there are many users and decision makers who are often confusedabout what they asked for and what they really need. A common scenario is a leader who is pushing for digital transformation realising what he had been advocating is really part of the enterprise system and business intelligence. The following table summarises the three phases of development of organisations.
Most healthcare organisations in China started with the age of electronic record and software in the 90s, with a handful a decade earlier. By early 2010s, most organisations had deployed more than 50 software. The main focus in this age was on creating software with functions that can replace manual operations. A full array of systems started to evolve— from a billing-centric HIS to various ancillary and specialised systems.
Moving into the mid 2010s, with the proliferation of integration tools, organisations moved into the age of systems and automation, where multi business lines started collaborating and exchanging data to fully automate operations. Simple decision tools emerged in the form of warnings, alerts and restrictions. Domain-based, such as outpatient, inpatient clinical systems, EMR, CDR were the main actors in this age.
The sophisticated data exchanges, siloed specialised systems and the need to have smarter decision support rallied the rise of the digital twin. Operations support and decision support are now in demand as IT systems need to decipher user situations, needs and potential risks in a holistic and immediate responsive manner, raising the stakes for digital systems to an unprecedented height. Fortunately, breakthroughs in technology such as large language models, ultra-high speed computing, smart sensory systems, opened the door and paved the way into the age of digital twin. Systems are now configured and perform around the role of users, with a wealth of models and knowledge bank supporting real-time.
Before we move into the pitfalls and recommendations, we need to understand why, besides policy, organisational leaders are pushing digital transformation:
With this understanding, it will be easier to align the strategic intent with actual execution, and also appreciate why the following pitfalls occur.
As an organisation matures, one can observe its shift in focus. This brings about the first pitfall that many organisations fall into: misinterpretation of current position. For example, Hospital A is still in the beginning of integrating the dozens of siloed systems installed and has not yet standardised its data standards and business processes. The management learn about digital twins and decide to invest heavily in digital products and digital twin systems. The gap in foundational data and crossfunctional integration will cause severe hurdles in the digital twins efforts, lowering the overall value created by the investment. End users may conveniently shift the blame to the digital systems, or make it a white elephant. Hence, it is critical for the leadership, IT team and business departments to carefully examine and identify its actual current position, and put sufficient emphasis and effort to build the necessary foundations.
The biggest difference between the age of the digital twin and its predecessors is the need to digitalise the underlying logic and causal relationships between different elements, roles, tasks and data. Unlike functionalities and data integration, this is a much more submerged relationship that requires careful studying or highly experienced digital and business experts to thread the relationship so that it reflects and predicts accurately the causal effect, and illustrates the twin-effect correctly. This need to understand both digital tech and business is the exact reason why IT engineers often fail to deliver digital transformation. Superficial mimicking or surface level observations cannot satisfy the deployment requirement of digital twins. Hence, it is dangerous to let IT lead digital transformation efforts and allow business leaders to take the back seat. The sequence should be the reverse to ensure success.
While it is absolutely critical for top leadership to command and control the transformation effort, relying solely on high level management and a small core teams is far from sufficient to promote a digital transformation effort. A common denominator for all digital transformation success is an all-in involvement from top leaders to the frontline users. The application of digital twins is often instantaneous, automated, and relies on a strong and wide data foundation. It is extremely difficult for a handful of leaders to manoeuvre the changes at this scale. The transformation effort needs to be executed at the edge of the organisation to ensure both the quality of the input and the suitability of the output tools. Hence, the digital literacy and readiness of the various echelons becomes a deciding factor on how fast and in what way the digital transformation is practised. The myth of using a single strong leader or a small core team to realise digital transformation needs to be recognized, and sufficient effort and resource needs to be put in roadshows, digital education, skillset training and other initiatives to improve the overall readiness level.
This necessitates a roadmap and transformation toolkit at your organisation’s disposal for planning and executing a digital transformation. The following are some tips to improve the success rate.
Digital transformation is an extremely challenging journey that, at critical junctures, requires a sense of belief to overcome hurdles. It is also a delayed response effort that requires its disciples to wait through the darkest hour before the light appears at the end of the tunnel. Hence it is important for every member of the organisation to understand why the organisation needs to transform and what value it can bring to the individual or the cause that the individual is serving. The lack of such translation will render the grand vision a fable that will be challenged and overthrown when difficulties mount. This calls for the vision to be simple to understand, fitting to the organisation’s history and culture and noble to the mission born by the organisation. It also means that extensive promotional effort is necessary to drive the message into every individual’s calling.
Within the organisation, different departments will likely be in different stagesof IT or digital maturity. Using the matrix above to map the current positioning realistically will enhance the feasibility of the roadmap and a better estimated investment scale. This will allow expectations to be better managed at the onset before the sense of misalignment ruins the morale and confidence of the team.
Any digital transformation journey will need a leader to achieve measurable success with low-lying fruits intermittently as the entire organisation pushes along the transformation effort. This will need the leadership and foundation of a business leader who can make immediate and direct decisions to affect digital initiatives. It is very challenging for IT leaders to take this pole position and overcome cross-department difficulties as well as possess the delicate sense of precise delivery needed in early stage effort to validate success. Business leaders will also be able to calibrate the right amount of measurable milestones that are audacious yet within reach, to achieve the greatest role model effect for the new transformation journey.
Politics, technology, market and regulatory requirements are the various reasons driving organisations in China to initiate digital transformation. It is important for the leadership to go in with eyes wide open and be ready to realign and re-innovate to tide through the journey and get the best out of the deal. Planning and management, execution and business value, frank self-assessment and acting with the risk tolerance of the organisation will be key success factors to avoid most pitfalls in digital transformation.
