A framework for success
The Digital Hospitals Handbook is the first of its kind in the world to be developed by any standards organisation. It is designed to provide a solid framework to maximise the chances of success of a digital hospital program.
At the turn of the century, information technology, or digital initiatives in health, was attracting bad press. Some criticisms were justified, others not.
Early adopters in the industry were learning and adapting rapidly and although there were sometimes challenges with timelines and budgets programs1, they were usually delivering quality objectives.
There was, however, a lack of confidence amongst senior stakeholders that digital hospital programs could be consistently delivered on time, on budget and achieve the target outcomes.
Injecting confidence into digital programs
An agreement was signed with Standards Australia to support the development of a handbook that would contain principles and recommendations to inform the design and implementation of digital hospitals. Members included experts from medicine, nursing, information technology, building projects, industry bodies (clinical and technical), and both public and private health sectors.
The handbook was recognised as the first of its type in the world to be developed by any standards organisation.
As an inaugural project with a diverse group of experts and stakeholders, the handbook itself was a challenging initiative. The goal was to provide principles and recommendations for the users, not technical advice. Balancing utility and shelf-life of the handbook was a core issue in the rapidly evolving worlds of health and IT; too general and the handbook would be of little use, too specific and its life would be short.
Fortunately there was no lack of enthusiasm or interest from committee members and other parties. After nearly two years of discussion, whiteboarding, reference site visits, drafting and extended peer review, the Digital Hospitals Handbook was published (SA HB 163:2017, Digital Hospitals Handbook).
Defining a digital hospital
Digital hospital initiatives are arguably the most complex, but also amongst the most rewarding, programs undertaken in the health system. The handbook defines a digital hospital, contains nearly 50 recommendations structured under six core principles and describes the application of these under phases of implementation from business case development through to benefits realisation. It includes a digital hospital vision and framework with referenced case examples.
In a digital hospital, practical knowledge about information management and information communications technology (IM&ICT) continually informs the design and adoption of new innovative models of care, with transformation extending out into the care continuum.
The target audience of the handbook is broad and so it was written in plain English with a comprehensive glossary. CEOs in particular are encouraged to consult the handbook prior to embarking on a digital hospital program.
A framework for success
The most important message the handbook conveys is that the development of a digital hospital is foremost about people (health consumers, health providers, and support staff), good governance, engagement and process. One of the six principles is devoted to leadership, staffing, risk management and governance. Other key issues include the consideration of organisational strategy in the planning phase and that program outcomes must be tightly aligned with organisational objectives.
Conversation in the committee meetings exemplified some challenges of language and perception of roles and activities in the space. “Architect? Which architect?” The builders were referring to the building architect and the IT experts meant the enterprise (information management and technology) architect. A common understanding of roles is critical to success since collaboration between design roles, in particular, is crucial to deliver on the objectives.
As the first of its type and with a defined budget and time frame, the handbook was also written to leave room for future versions. Nevertheless, the handbook in its current form provides a solid framework to maximise the chances of success of a digital hospital program.
1. The word program, rather than project, is used deliberately when referring to a digital hospital initiative. There was agreement that these initiatives are never a single project but rather a complex program of interdependent projects.
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