The term ‘clinical transformation’ has been in circulation in the healthcare circuit for a while now. The term, coined in 2001 in the “Crossing the Quality Chasm” report in the Institute of Medicine’s (IOM) publication, revealed the changes that the existing healthcare system demanded in order to become safer, more effective and increase cost efficiencies.

In 2011, Healthcare Information and Management Systems Society (HIMSS) defined clinical transformation as follows “Clinical transformation involves assessing and continually improving the way patient care is delivered at all levels in a care delivery organization. It occurs when an organization rejects existing practice patterns that deliver inefficient or less effective results and embraces a common goal of patient safety, clinical outcomes, and quality care through process redesign and IT implementation. By effectively blending people, processes, and technology, clinical transformation occurs across facilities, departments and clinical fields of expertise.”

The Need for Clinical Transformation

In the age of consumerization, the healthcare industry is also being governed by the rules that apply to other sectors such as finance, banking, retail etc. Given that healthcare costs are rising incrementally, the patients, i.e. the consumers of healthcare, want to ensure that they get reliable and efficient service quality. However, the healthcare environment is quite complex and has its own diverse set of complex demands and requirements. Despite this, it is quite clear that the expectation from the healthcare sector is that it will be “safe, effective, efficient, timely, patient-centered, equitable, and beneficial”. Clinical Transformation is, thus, becoming imperative to address the concerns of high costs, improve patient outcomes, and improve efficiencies of the entire healthcare ecosystem.

In order to achieve clinical transformation, there has to be an effective alignment of people, process, and technology. Transformation initiatives cannot be successful if they focus on any one of these. It has to be understood that while technology is a critical enabler of healthcare transformation, it by itself, cannot be a driver of change. The aim of clinical transformation is to create a sustainable change in the care delivery process for better patient outcomes and to create a positive impact on the financial metrics. To enable this, organizations need to create a transformation framework that places an equal emphasis on people and process as well.

The Approach to Clinical Transformation

People

People have always been the drivers of change. In order to achieve clinical transformation, healthcare organizations have to take into consideration the people who will be most affected by the change. In the healthcare scenario, this can be a little complicated since the professionals involved come from different disciplines and backgrounds with their own set of ideas of how clinical work should be executed. Since people and historical processes set the culture of any organization, to implement clinical transformation, it becomes imperative to involve the key stakeholders in the process.

To help drive the change process and make the transformation initiatives achieve success:

  • Assess the degree of readiness to accept change amongst physicians, healthcare workers and the leadership – both administrative and managerial
  • Involve the clinicians in the transformation process
  • Establish clear and transparent methods of communication between the invested stakeholders
  • Create an environment that helps in creating a shared need within the organization.

Process

Change initiatives demand to take a disciplined approach towards identifying means for performance improvements. For successful clinical transformation, it becomes imperative to:

  • Assess the current state of work
  • Identify process gaps and loopholes within the same
  • Develop a vision of how the work processes should function
  • Identify the required capabilities for systems to enable and support these initiatives

Unless gaps in the existing processes are identified, healthcare organizations will only end up adding more processes on top of the old processes, thereby increasing the workloads without any effective performance improvements and their efforts will ultimately be rejected by the stakeholders.

To achieve clinical transformation, healthcare organizations, thus, have to focus on process redesign by taking a structured approach to it which includes paying attention to change management, quality assessment and testing, IT transition, project management time frames, identifying where to implement deployment efforts, assessing the decision support systems that need to be in place to support physicians, and taking a transparent approach to transformation. Organizations also have to measure their current state as the basis of measuring success for all future initiatives in a continuous manner to assess if the new processes are enabling faster work execution and increasing performance efficiencies across the healthcare organization.

Technology

Technology has been a driver of change across industries and healthcare is no different. Clearly, making the right technology decisions are critical to the success of any clinical transformation initiative. However, technology decisions should not be isolated to the IT department alone and should also include the users of the technology. Technology decisions should be patient-centric and should aim to provide patient information, patient data, and all other related information to physicians and caregivers to improve the care process and enhance the healthcare ecosystem. Technology should take an integrated approach to allow sharing of real-time information between departments and should provide simultaneous access to multiple data – this will help in not only improving the patient care outcomes but also improve efficiencies and promote the system usage.

The success of clinical transformation initiatives lies in the value creation that stems from tying together people, process and technology with operations to enable breakthrough performance enhancements. Clinical transformation initiatives demand a culture change and hence, it becomes essential to assess the organizational readiness for change and assess the degree of change that needs to be implemented and resource commitments and focus in order for these to be successful. Thus, adopting a strategy that has the right people, identifies the right processes and implements the right technology lead to positive results in the clinical transformation journey.