Digital Transformation in Healthcare: An Ecosystem Approach
Book Summary
This is a summary of my book, titled, “Digital Transformation in Healthcare: An Ecosystem Approach”, published by Routledge. More information about the book can be found here.
In recent years, the world has experienced significant disruption by such major shocks as the COVID-19 pandemic, but also the coming of age of generative AI, both of which have accelerated digital transformation. The COVID-19 pandemic has highlighted the urgent need for digital solutions that can improve patient outcomes, increase operational efficiency, and ensure access to healthcare services. The pandemic has forced healthcare organizations to rapidly adopt digital solutions, such as telemedicine and remote monitoring, to ensure continuity of care and reduce the risk of infection. As a result, the adoption of digital health solutions has accelerated significantly, and many of these changes are likely to become permanent.
In addition, the rapid pace of technological change through digital technologies such as artificial intelligence, cloud computing, and the Internet of Medical Things, but also biotechnologies such as mRNA and whole genome sequencing have enabled the development of new digital health solutions, most notably in personalized or precision medicine, which were not possible a decade ago. Patients are becoming more active and empowered in managing their own health and wellness through personal smart devices and they are putting significant pressure on healthcare service providers to become more efficient and effective.
However, there are also challenges to implementing digital transformation in healthcare. These include limited resources, infrastructure, and skills, as well as regulatory and cultural barriers. Indeed, these challenges are faced by healthcare organizations in both developing and developed economies. For example, a recent study in the English NHS found evidence of an “impending crisis, with capital restrictions limiting investment in buildings, infrastructure and equipment”, all of which force the implementation of “rationing” practices, service dilution, delay and selection that impact the quality and safety of care.
Many of these inefficiencies are due to the limitations of hierarchical forms of organizing healthcare services, including bureaucratic decision-making infused with political agendas, that drive up the costs of healthcare services including treatment options, diagnostics and hospital care. There is also a rising doctor and carer burnout across national health systems due to increased workloads, low numbers of staff and other resource constraints, which contribute to medical errors and poor performance, feeding into a vicious cycle of increased costs. These complex challenges are aggravated by the lack of interoperability between information systems and applications, as well as issues of data access. In addition, there are ethical and regulatory challenges to governing data generated through, and accessed by, new innovations in healthcare.
The need for a book on digital transformation in healthcare is more urgent now than ever before. Disruptive forces are transforming the healthcare sector in fundamental ways that require executives in healthcare organizations to be more proactive and strategic in their approach to digital transformation. No single organization can navigate the complexity of the healthcare landscape on its own. No single organization has all the necessary resources and capabilities to innovate on its own. Rather, organizations need to develop collaborative partnerships with different actors to synergistically combine complementary resources and capabilities across healthcare ecosystems.
The key contribution of this book is a framework to help organizations leverage digital technologies across ecosystems in their transformation programs. Developing their own ecosystem or becoming a partner in other ecosystems is not simply about technology. It is about collaborating on complex problems and finding innovative solutions, establishing governance rules for managing risks and resolving collective action problems, and building joint value propositions that generate virtuous value creation opportunities for all ecosystem actors.
The book builds the rationale for an ecosystem approach to digital transformation, develops and applies the approach and discusses regulatory challenges over three parts and seven chapters. PART 1 sets the scene, with Chapter 1 reviewing the major forces disrupting healthcare services and defining key concepts, including disruption, digital transformation, digital maturity and ecosystems. This chapter discusses the emergence of multiple ecosystems, both small and large, and involving different ecosystem actors. Chapter 2 then provides a deep dive into the key challenges faced by healthcare organizations across the world, primarily because of the prevalence of hierarchical forms of organizing healthcare services. It provides examples of both incumbent organizations in the public and private sector, but also new startups and their efforts to manage challenges ranging from the rising costs of healthcare services, to interoperability challenges between diverse technologies, to ethical and regulatory challenges around data governance. Finally, PART 1 describes how organizations can lead change toward achieving higher value for patients. Value is discussed in relation to the healthcare delivery cycle, exploring how different ecosystem actors get involved in this cycle’s distinct processes, going beyond healthcare service providers, to also examine the role of medical device manufacturers, diagnostic centers, biotech and pharmaceutical companies and digital service integrators, among others. Following this discussion, the focus shifts to how each of these ecosystem actors can develop unique value propositions by leveraging digital technologies. Chapter 3 outlines different levels of digital maturity, offering a blueprint by which healthcare organizations can identify where they stand and how they can begin to digitally transform themselves.
PART 2 is the core of the book providing a detailed discussion of the ecosystem approach to digital transformation. First, Chapter 4 lays out a framework of how organizations can digitally transform their services across an ecosystem, including how to define their digital transformation problem, clarify their incentives and activities, but also how to develop an innovation and adoption plan in collaboration with their partners, while governing associated risks. The chapter draws heavily on the example of the Siemens Healthineers’ ‘teamplay digital health platform’, which enables diverse organizations, from hospitals to diagnostic centres, to benefit from a modular, vendor-agnostic infrastructure and digital applications provided by third party complementors on demand. The chapter discusses both the opportunities and collective action problems that may emerge in such ecosystems and also provides ways of effectively managing those while ensuring the sustainability and growth of the ecosystem. Chapter 5 discusses ways how healthcare organizations can form ecosystems on blockchain infrastructures. This chapter describes how blockchain infrastructures work, how transactions take place and how they enable distributed data governance. It then provides a discussion of use cases of blockchain infrastructures in healthcare provided by PharmaLedger, focusing on recruiting patients and achieving informed consent in clinical trials, and achieving trusted transactions through electronic product information in pharmaceutical supply chains. The chapter concludes by discussing the co-innovation and co-adoption challenges of the use of blockchain infrastructures in healthcare. Chapter 6 discusses ways by which healthcare organizations can form ecosystems on federated learning infrastructures. The chapter describes how cloud computing works, before exploring data virtualization and federated learning infrastructures. It then discusses two use cases of federated learning in healthcare ecosystems, one in medical imaging used during the COVID-19 pandemic and one in genomics research hosted on the Lifebit platform. The chapter concludes by discussing the co-innovation and co-adoption challenges of the use of data virtualization in healthcare.
PART 3 concludes the book by discussing the recent coming of age of generative AI technologies, including OpenAI’s Chat GPT-4, Microsoft’s Bing AI and 365 Copilot, but also Meta’s LLaMA and Google’s Bard. Chapter 7 provides an analysis of this very turbulent landscape and discusses ways by which organizations can navigate digital transformation by using generative AI technologies. The chapter provides a discussion of both the possibilities and challenges of generative AI in healthcare, before diving deep into the race to tech arms between big tech companies, open-source developers and healthcare organizations. The chapter concludes by examining recent regulation on AI technologies and makes a set of proposals for technology policy to govern generative AI in healthcare.
The book is written for executives and key decision makers in healthcare organizations. It provides a strategic blueprint for helping organizations transform their operations and improve patient outcomes. Regulators and policy-makers, but also empowered patients will also find the book useful in navigating the complexity of the healthcare landscape.
The book is available on Amazon. Email me for a discount code.
https://www.amazon.co.uk/Digital-Transformation-Healthcare-Ecosystem-Approach/dp/1032171111