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June 23, 2017
Harnessing culture change to realise digital healthcare benefits
By: Dan West

Could the paperless NHS not be worth the paper it isn’t written on?

Let’s get a couple of things out of the way: a paperless NHS without user-centred redesign of processes would most probably deliver the same quality of services as before—with the same challenges. This isn’t really news. Neither is the fact that user centred design is a central tenet of digital transformation. Our recent CIO survey indicates CIOs need to transform their organisations to meet consumers’ growing demands, and to leverage digital technology to lower operational costs.

So—do I think all healthcare IT teams should embrace “agile ways of working,” grow beards and move their operations to Old Street? Maybe—but I think the growing momentum to understand what digital transformation is actually about is more important, as is understanding how it can help NHS CIOs and clinical transformation leaders to achieve the changes needed in the health sector.

Cultural change

This is about cultural change, not technology delivery projects. It’s about interoperability and getting the best out of your existing systems, not big investments in new applications. It’s about experimental attitudes and engagement of the whole workforce in the process, not servers and networks. And it’s about user centred service redesign, not project governance1.

"Significantly increasing the digital skills of a technically advanced minority is far less effective than slightly increasing the digital skills of the whole community."

It sounds deceptively mundane, but in my experience the best way to achieve the desired focus on cultural change, interoperability, appropriately experimental attitudes and user centricity is by storytelling and observation. Why? Significantly increasing the digital skills of a technically advanced minority is far less effective than slightly increasing the digital skills of the whole community. People love stories, to show how successful adoption of Digital has helped elsewhere. The blogs alongside the Accenture CIO survey begin to do this, but if you’re reading this and want to share your stories, we’d love to hear them—please comment or let us know.

Four keys to digital value from NHS CIOs

From “view,” to “do.” The shared patient record portal trap: Universal access to common healthcare information is a leap forward in digital transformation, right? Maybe not. When limitations in bidirectional workflow arise, people often revert to old processes. Service design approaches could optimise investment at the outset.

Achieving value early—experiment with analogue options today to find better digital options for tomorrow: Online pre-surgical assessments, pre-admission home-based data collection, are a leap forward in digital transformation, right? Sure, but a simple phone, while more labour intensive for the clinic concerned, can achieve equally good, if not better, patient insight today. Proving the value today, allows for more confident investments in more sophisticated technology solutions tomorrow.

Regional collaboration works: Amplify the return on technology investments. One NHS region coordinated across health and social care organisations to achieve shared Wi-Fi services and a common user-ID management platform. Ecosystem-level coordination pays dividends in terms of flexible working practices and improved workforce engagement.

The cure can still be optimised, even if prevention is better: While big savings come from moving care out of high cost settings through prevention, there are still potential gains in the hospital. Legacy silo technology systems and data make it is difficult for clinicians to get a single-glance view of a given patient’s data. CIOs talk about the need for clinicians to “go on a data hunt” across systems to get the complete view of a record.

Different NHS leaders have different views on what digital health is all about. Arriving at a common vision, and using experiences and stories from successful projects to show people the art of the possible, helps to align them around a common goal. Recognising that achieving the goal is as much about the people, leadership and processes as the technology, is crucial to getting there.

Let us know your thoughts!

1Some of these things will certainly be needed at some point, but should not be the primary focus and language of the IT / change teams.

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