Navigating Headwinds in Digital Health Transformation: Decision-Making, Obstacles, and Success

As an experienced stakeholder in the digital health field, it's not just the decision-making process that can be challenging, but also navigating the various headwinds that come our way. After leading decades of projects, products, and large-scale transformations, I've become quite familiar with the terrain, including the obstacles and challenges that lie ahead. Over time, it starts to feel like watching the same movie again and again, with increasingly predictable outcomes. When we encounter these repetitive patterns of pushback, doubts, disagreements, or hesitations, it's a perfect moment to hit pause and ask ourselves if we're ready for another rerun:

1. How confident am I in the success of this project?
2. Are all stakeholders aligned on the definition of success?
3. How well-equipped are we to address potential challenges or roadblocks?
4. What is the level of buy-in and commitment from team members and leadership?
5. How will we manage change and ensure a smooth transition for all involved?
6. Have we identified and addressed any skill gaps in our workforce to support the transformation?
7. What measures will we take to minimize disruption to our day-to-day operations?
8. How will we track progress and adjust our strategies as needed throughout the transformation process?

These inquiries are natural and often remain unspoken. By posing these questions and carefully examining the responses, we can gain deeper insights into the project's likelihood of success and implement any essential modifications to enhance the results. What are the true keys to guaranteeing success?

First step: Reduce the impact of failure

Failure is inevitable. Failure is OK. Without failure we will never evolve or learn. How do we reduce the impact of failure and optimize for success? It’s important to consider three key lenses: feasibility, viability, and sustainability. Feasibility refers to ensuring that your project is possible to implement. Viability means that the project is designed to work well and be effective. Sustainability relates to ensuring that the project can continue over the long term. By continuously looking through these three lenses, you can help maximize your chances of success.

If you're acquainted with Design Thinking, you may have come across the concepts of Feasibility, Desirability, and Sustainability. The optimal innovation process embodies a perfect balance of desirability, feasibility, and viability—a notion first introduced by IDEO.

In my perspective, I elevate sustainability to the same rank as feasibility and viability. While desirability certainly holds significance, I've observed that long-term failures in healthcare often stem from inadequate sustainability planning and execution.

FEASABILITY

Feasibility plays a crucial role in innovation, yet it can often be misinterpreted, particularly in interoperability projects such as integrating disparate electronic health record systems. Frequently, stakeholders involved in the project may lack a comprehensive understanding of the various perspectives that factor into designing, constructing, and utilizing the system.

To accurately assess a project's feasibility, it is imperative to gather input from all stakeholders via crowdsourcing. Mere agreement in a meeting that a project is promising does not guarantee success, nor can a project's intricacies be fully grasped in a brief gathering. For instance, if you're working on an interoperability project involving Epic Health and a text messaging platform, it's vital to include representatives from both Epic Health and other integrated systems. This group should encompass engineers, practice managers, content editors, clinicians, and patients, as each of these stakeholders possess vital insights into the product's design, execution, and post-launch maintenance.

To accomplish this, it's essential to have a team member who can spearhead collaborative sessions, either in-person or virtually. This individual should organize a feasibility workshop aimed at understanding all the interactions and activities necessary for realizing a new innovation. This process may encompass infrastructure, design, billing, and content. Subsequently, at a high level, an outline of the requirements for building all these components should be established.

Luckily, we've got some amazing tools and templates at our disposal, like Miro or Lucidspark, which are perfect for virtual teamwork. With these handy resources, you can whip up a service blueprint, work breakdown structure, or mind map in just a couple of hours. Check it out here on Miro, or Lucidchart. Miro Lucid Software

Once you've gained a thorough understanding of a project's true intricacies, you can assess its feasibility, scope, and the necessary resources to forge ahead. This enlightening process often unveils gaps in staffing, processes, or technology. It's far more advantageous to identify these gaps early, rather than pouring substantial time and resources into a project. Ultimately, this approach mitigates the risk of encountering issues later on.

Additionally, this strategy substantially alleviates political headwinds.

VIABILITY

As an IT & UX pro, it's crucial to teach stakeholders about the value and outcomes of tech projects in digital health. Grasping the complexity and cost implications is vital for a project's feasibility. Without a deep dive into resources and trust in those creating, building, and using a system, goals often go unmet. However, be cautious of red flags like sales teams claiming their products need minimal effort from IT or suggesting a "plug-and-play" approach. Do your homework and don't confuse confidence with proof.

Assessing a digital product's potential is key to determining its success. User experience research should always be part of a project, but sometimes it's skipped during the initiation phase. To avoid missing user needs and feedback, evaluate your users and shadow them—whether they're clinicians or patients. This approach helps us better understand the current state and more accurately answer important questions like, "Will our product work?" and "Is it solving real problems for users?" Everything sounds awesome in the first meeting, but balancing it with user-based research ensures our digital products are viable solutions that genuinely help those who use them.

User experience is the heart of a successful digital product. Viability is the ultimate factor in determining success, making user research a critical part of the process. Design thinking can bridge user needs with outcomes by involving users in participatory design. Usability and user research should always be considered when figuring out if there's a need for a tech solution. Validation methods like user testing and shadowing can reveal user behaviors that might've been overlooked. Through user research, teams can create products that meet users' needs and objectives on both individual and organizational levels—validating your project's KPIs (Key Performance Indicators) and OKRs (Objectives & Key Results). Plus, it's way cheaper to pivot based on user research than buying a product and finding out you need to change course halfway through the project.

SUSTAINABILITY

When it comes to long-term success for any project or innovation, sustainability is an absolute game-changer. It's easy to get caught up in the initial excitement of creating something new, but we need to remember that keeping it up and running is what truly matters in the long run. In the world of digital health, for instance, it's crucial that tools, workflows, and products are consistently updated and maintained to stay effective.

One of the trickier parts of achieving sustainability is getting buy-in from everyone involved. People might be enthusiastic about the project in its early stages, but it's important to make sure they understand that their commitment doesn't end once it's built. It's about creating a lasting solution that requires ongoing effort and attention.

Navigating the complexities of identifying and securing the right people to be responsible for sustained maintenance and continuous improvement can be challenging. It's essential to communicate the importance of this commitment from the start, ensuring that everyone knows their role and what's expected of them. This means setting clear expectations for maintaining and improving the tool or workflow and holding people accountable for meeting those expectations.

Another important aspect is fostering a culture of continuous improvement where everyone feels encouraged to contribute their ideas and insights to help make the tool or workflow better over time. This collaborative mindset can help identify potential issues early on and allow for adjustments to be made proactively.

Don't be afraid to ask for help early on, either. It's better to acknowledge that you might need assistance with sustainability at the beginning of the project, rather than waiting until problems arise. By being proactive, you can create a strong foundation for your project's long-term success.

In the end, sustainability is the key to making any innovation or project truly successful. By recognizing the importance of ongoing maintenance and improvement, ensuring that the team responsible for sustaining the tool or workflow is committed and accountable, and fostering a culture of continuous improvement, you'll set your digital health projects up for lasting success.

Navigating the headwinds

Conflict resolution is key when people see things differently. It's all about understanding each other's views and the project's main goal, while checking if it's realistic, doable, and lasting. For tech projects in digital health, we need to look at the issue, what we want to achieve, and the targets to know if it's worth it. Keep reevaluating everyone's thoughts to make steady decisions.

Make sure discussions about tech projects stay unbiased. Once everyone's on board with a decision, use presentations and weekly updates to keep everyone in the loop and tackle any roadblocks. Keep goals super clear and use balanced scorecards so everyone knows how things are going.

To guarantee success, ensure you follow these five steps:

1. Trust is essential. Focus on building trust with stakeholders at every level. Your biggest obstacle will be where trust is lacking. Nothing tops having 1:1 in-person chats, so seek them out—even if it means dropping by their office!
2. Get everyone on the same page about what success looks like from the get-go, and revisit this vision throughout the process.
3. Always consider complexity, value, and user experience in all of your decision-making.
4. Set yourself up for lasting success by assembling a team to not only execute the project but also establish a dedicated operational team to ensure its ongoing maintenance.
5. Lastly, it's crucial to continually reassess feasibility, viability, and sustainability, as these factors will evolve over time!