Abstract
BackgroundHospitals worldwide are developing ambitious digital transformation programs as part of broader efforts to create digitally advanced health care systems. However, there is as yet no consensus on how best to characterize and assess digital excellence in hospitals.ObjectiveOur aim was to develop an international agreement on a defined set of technological capabilities to assess digital excellence in hospitals.MethodsWe conducted a two-stage international modified electronic Delphi (eDelphi) consensus-building exercise, which included a qualitative analysis of free-text responses. In total, 31 international health informatics experts participated, representing clinical, academic, public, and vendor organizations.ResultsWe identified 35 technological capabilities that indicate digital excellence in hospitals. These are divided into two categories: (a) capabilities within a hospital (n=20) and (b) capabilities enabling communication with other parts of the health and social care system, and with patients and carers (n=15). The analysis of free-text responses pointed to the importance of nontechnological aspects of digitally enabled change, including social and organizational factors. Examples included an institutional culture characterized by a willingness to transform established ways of working and openness to risk-taking. The availability of a range of skills within digitization teams, including technological, project management and business expertise, and availability of resources to support hospital staff, were also highlighted.ConclusionsWe have identified a set of criteria for assessing digital excellence in hospitals. Our findings highlight the need to broaden the focus from technical functionalities to wider digital transformation capabilities.
Highlights
It is widely recognized that health information technology (HIT) has significant potential to transform health care systems and support continuous quality improvement efforts [1]
The technological capabilities fell into two categories: (a) capabilities within a hospital, and (b) communication with other parts of the health care system, and with patients and carers
The need to distinguish between capabilities within hospitals and those relating to the broader context of the health care ecosystem was emphasized in free-text comments, for example: There is an important assessment on where enterprises are, versus where those enterprises sit in an ecosystem and how they interact with those wider ecosystems. [Vendor]
Summary
It is widely recognized that health information technology (HIT) has significant potential to transform health care systems and support continuous quality improvement efforts [1]. There are various ways to conceptualize and measure digital excellence in health care [4,5] These approaches vary in scope from highly specialized models, focusing on a specific technological subsystem [6] to those assessing digital transformation across an entire hospital, and others encompassing the wider integrated health and care ecosystem [7]. The origin of these models is diverse, including international health care industry organizations such as the Healthcare Information and Management System Society (HIMSS) Analytics [8], national health care providers [9], and academic groups [10]. Our findings highlight the need to broaden the focus from technical functionalities to wider digital transformation capabilities
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