Driving digital health transformation in hospitals: a formative qualitative evaluation of the English Global Digital Exemplar programme.
health information systems
program evaluation
Journal
BMJ health & care informatics
ISSN: 2632-1009
Titre abrégé: BMJ Health Care Inform
Pays: England
ID NLM: 101745500
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
11
06
2021
accepted:
22
11
2021
entrez:
18
12
2021
pubmed:
19
12
2021
medline:
22
12
2021
Statut:
ppublish
Résumé
There is currently a strong drive internationally towards creating digitally advanced healthcare systems through coordinated efforts at a national level. The English Global Digital Exemplar (GDE) programme is a large-scale national health information technology change programme aiming to promote digitally-enabled transformation in secondary healthcare provider organisations by supporting relatively digitally mature provider organisations to become international centres of excellence. To qualitatively evaluate the impact of the GDE programme in promoting digital transformation in provider organisations that took part in the programme. We conducted a series of in-depth case studies in 12 purposively selected provider organisations and a further 24 wider case studies of the remaining organisations participating in the GDE programme. Data collected included 628 interviews, non-participant observations of 190 meetings and workshops and analysis of 9 documents. We used thematic analysis aided by NVivo software and drew on sociotechnical theory to analyse the data. We found the GDE programme accelerated digital transformation within participating provider organisations. This acceleration was triggered by: (1) dedicated funding and the associated requirement for matched internal funding, which in turn helped to prioritise digital transformation locally; (2) governance requirements put in place by the programme that helped strengthen existing local governance and project management structures and supported the emergence of a cadre of clinical health informatics leaders locally; and (3) reputational benefits associated with being recognised as a centre of digital excellence, which facilitated organisational buy-in for digital transformation and increased negotiating power with vendors. The GDE programme has been successful in accelerating digital transformation in participating provider organisations. Large-scale digital transformation programmes in healthcare can stimulate local progress through protected funding, putting in place governance structures and leveraging reputational benefits for participating provider organisations, around a coherent vision of transformation.
Sections du résumé
BACKGROUND
BACKGROUND
There is currently a strong drive internationally towards creating digitally advanced healthcare systems through coordinated efforts at a national level. The English Global Digital Exemplar (GDE) programme is a large-scale national health information technology change programme aiming to promote digitally-enabled transformation in secondary healthcare provider organisations by supporting relatively digitally mature provider organisations to become international centres of excellence.
AIM
OBJECTIVE
To qualitatively evaluate the impact of the GDE programme in promoting digital transformation in provider organisations that took part in the programme.
METHODS
METHODS
We conducted a series of in-depth case studies in 12 purposively selected provider organisations and a further 24 wider case studies of the remaining organisations participating in the GDE programme. Data collected included 628 interviews, non-participant observations of 190 meetings and workshops and analysis of 9 documents. We used thematic analysis aided by NVivo software and drew on sociotechnical theory to analyse the data.
RESULTS
RESULTS
We found the GDE programme accelerated digital transformation within participating provider organisations. This acceleration was triggered by: (1) dedicated funding and the associated requirement for matched internal funding, which in turn helped to prioritise digital transformation locally; (2) governance requirements put in place by the programme that helped strengthen existing local governance and project management structures and supported the emergence of a cadre of clinical health informatics leaders locally; and (3) reputational benefits associated with being recognised as a centre of digital excellence, which facilitated organisational buy-in for digital transformation and increased negotiating power with vendors.
CONCLUSION
CONCLUSIONS
The GDE programme has been successful in accelerating digital transformation in participating provider organisations. Large-scale digital transformation programmes in healthcare can stimulate local progress through protected funding, putting in place governance structures and leveraging reputational benefits for participating provider organisations, around a coherent vision of transformation.
Identifiants
pubmed: 34921060
pii: bmjhci-2021-100429
doi: 10.1136/bmjhci-2021-100429
pmc: PMC8685936
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
J Am Med Inform Assoc. 2004 May-Jun;11(3):207-16
pubmed: 14764612
J Med Internet Res. 2020 Aug 18;22(8):e17022
pubmed: 32808938
J Med Internet Res. 2020 Jun 10;22(6):e15068
pubmed: 32519968
Int J Med Inform. 2013 May;82(5):e87-95
pubmed: 23287413
J Gen Intern Med. 2006 Feb;21 Suppl 2:S50-7
pubmed: 16637961
BMC Med Inform Decis Mak. 2012 Nov 05;12:123
pubmed: 23126370
PLoS Med. 2009 Aug;6(8):e1000126
pubmed: 19688038
Int J Qual Health Care. 2007 Dec;19(6):349-57
pubmed: 17872937
N Engl J Med. 2017 Sep 7;377(10):907-909
pubmed: 28877012
BMJ Open. 2020 Oct 8;10(10):e041275
pubmed: 33033100
Health Aff (Millwood). 2017 Aug 1;36(8):1416-1422
pubmed: 28784734
BMJ. 2008 Oct 23;337:a1786
pubmed: 18948344
BMJ Qual Saf. 2016 Apr;25(4):226-32
pubmed: 26369894
BMJ. 2007 May 19;334(7602):1030-1
pubmed: 17510148
N Engl J Med. 2010 Aug 5;363(6):501-4
pubmed: 20647183
Med J Aust. 2007 Jan 1;186(1):3-4
pubmed: 17229021
Stud Health Technol Inform. 2008;136:419-24
pubmed: 18487767
Am J Manag Care. 2014 May;20(5):418-23
pubmed: 25181570
N Engl J Med. 2017 Sep 7;377(10):904-906
pubmed: 28877013
J Am Med Inform Assoc. 2015 Jul;22(4):849-56
pubmed: 25882032
Int J Med Inform. 2011 Mar;80(3):157-70
pubmed: 21292546
AMIA Annu Symp Proc. 2006;:982
pubmed: 17238601
J Med Internet Res. 2017 Jul 07;19(7):e244
pubmed: 28687532
Stud Health Technol Inform. 2008;136:303-8
pubmed: 18487748
Lancet Digit Health. 2019 Sep;1(5):e200-e201
pubmed: 33323267
BMC Health Serv Res. 2020 May 27;20(1):477
pubmed: 32460830
Int J Med Inform. 2008 Dec;77(12):848-54
pubmed: 18657471
Int J Med Inform. 2001 Dec;64(2-3):157-71
pubmed: 11734383
J R Soc Med. 2021 Mar;114(3):111-112
pubmed: 33259251
Int J Med Inform. 2014 Jun;83(6):393-405
pubmed: 24656180
J Am Med Inform Assoc. 2021 Jul 14;28(7):1431-1439
pubmed: 33706378
BMJ. 2005 Aug 6;331(7512):331-6
pubmed: 16081447
J Am Med Inform Assoc. 2008 May-Jun;15(3):297-301
pubmed: 18308984
J Med Internet Res. 2017 Nov 01;19(11):e367
pubmed: 29092808
Milbank Q. 2011 Dec;89(4):533-63
pubmed: 22188347
J Am Med Inform Assoc. 2003 Jan-Feb;10(1):1-10
pubmed: 12509352
Qual Saf Health Care. 2010 Oct;19 Suppl 3:i68-74
pubmed: 20959322
Crit Care. 2008;12(6):R148
pubmed: 19025662
J Biomed Inform. 2005 Feb;38(1):51-60
pubmed: 15694885