Digital transformation in government: Lessons for digital health?

Abstract

Globally, there is a movement for outstanding digital services in government; in many countries, this extends to healthcare. And if digital health is to be delivered at scale, there needs to be involvement from multiple stakeholders, and government often has a central role. Understanding how governments are planning digital transformation generally, and in healthcare in particular, is important for other stakeholders. First, achieving sustainable change at scale will often involve working with government. Second, how governments are approaching these challenges can provide useful lessons for others in the field. In this paper, we describe some common trends in digital transformation in government and how they apply to the health sector, using NHS England as a leading exemplar. People expect their government transactions, like renewing a passport online or paying tax, to deliver the same calibre of service as they receive from online banking or online shopping. The processes by which successful corporations have transitioned towards digital maturity are being replicated in the public sector. The extent of governments’ adoption of contemporary product development methodologies can be seen when books such as that of Eric Reis, The lean startup,1 are found on the desks of senior leaders. The goal of digital transformation for companies is clear: save money by making digital services so good that people simply prefer to use them. Amazon and Netflix did not need to train people to use their service – they created a superior service that actively responded to the needs of users in a dynamic way, with an intuitive layout. These services became the de facto way of doing business; this is digital by default. However, digital governance and ownership is in its infancy in many organisations, both in the private and public sector. The transition to a mature digital governance model within a longstanding organisation is a complex and disruptive journey. It can be challenging when organisations conceptualise digital transformation as a clearly defined change management exercise, rather than a fundamental shift in how the organisation as a whole functions. Many organisations erroneously view digital transformation as primarily about the implementation of IT systems, rather than as a new of way working facilitated by advancements in technology, a mistake often seen in healthcare too.2,3