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The Challenge of Fractured Governance: Digital Health Innovation

Once upon a time, it was simple. The IT department took care of technology implementations and kept the trains (emails) running. Marketing had a distinct set of tools, operating within relatively clear parameters. Clinical applications operated in their own silos, and that was just fine.

Operational and workflow systems had their own idiosyncrasies. Imperfect, but at least understandable and with independent, skillset-specific KPIs (and perhaps even SLAs) existed for every department and business unit.

Fast forward to the digitally integrated healthcare organization of today, and the impact of technology-driven convergence is readily apparent. Health systems and payers alike have a wide choice when it comes to on-premises, cloud-based, and hybrid solutions, as well as multi-faceted business analytic tools to harvest data from virtually every environment.

The integration of back-office, front-office, clinical, and digital interactions enable organizations to drive customer experience and improve health outcomes like never before.

When it comes to organizational culture and process, however, payers and providers have arguably some of the most compartmentalized, hierarchical structures of any industry (admittedly often with good reason), and many lag behind the pace of transformation and change occurring in other industries.

A truly cross-functional view of technology priorities is not common, even in entities with relatively less-complex footprints. However, many organizations still support federated business decision making and budgeting, while organizational goals remain centered on driving business value by focusing on the customer, the patient, the member, or the provider, and striving to gain the highest possible yield from these relationships, interactions, and digital health transactions.

The Chief Digital Officer role is part (but only the start) of the solution. A “digital first” mindset has to take root across the organization, with coordinated prioritization as the mantra. Digital health is not solely an IT consideration.

Nor is it just a marketing consideration, a clinical consideration, or a product, finance, or revenue cycle consideration. Culturally, it must become a North Star across organizational sub-structures, with shared goals and shared metrics.

For example, successfully implementing an integrated onboarding solution that supports a patient’s logistical journey from eligibility to virtual visit to wayfinding is clearly a win, but

it is not simply a win for one digital team. It is a win for the clinicians that helped select a vendor that safely delivered an appropriate level of care and accuracy, of course.

It is also a win for the IT department that worked through multiple APIs to force fixes, and a win for the social media team that used a new algorithm to target posts. It is a win for each discreet team that ticked a box in a work plan that created the solution.

As digital becomes more pervasive and influential, the drivers of and responsibility for any given digital technology’s success are spread through the organization. Digital health solutions often represent a fundamental change in ‘how things are done’ and therefore bring parts of an organization together in new ways – ways that are not always comfortable. Governance models that embrace the organizational tension that this process creates will set winners apart.

The Diagnosis

Digital innovation initiatives in healthcare often suffer when ownership and metrics for success live in functional silos.

Course of Therapy

Healthcare organizations need to design dedicated, flexible governance structures to coordinate cross-organizational digital health initiatives.

The structure requires early executive buy-in and transparent communication to the many teams impacted. Breaking down silos, asking employees to work differently, manage different relationships, and learn new norms can be empowering, but can also become stagnating without clear leadership.

Learn how to overcome digital health transformation challenges and drive positive organizational change, innovation, and insight by downloading this free guide here.

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David Allen

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