eHealth and Healthcare Organisation The Chicken and the Egg. Huguet M. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

1. eHealth and Healthcare
Organisation
The Chicken and the Egg
Dr. Mateu Huguet
Institut d’Estudis de la Salut
Barcelona, March 17th 2010

2. Agenda
1. Technology and Healthcare
2. Round table questions
3. Warm-up Survey Results

3. Technology and Healthcare

4. Technology and Healthcare
Innovation
Healthcare Technology
Quality
Patient Safety
Efficiency
Professional and organizational
development

5. IT Learning curve
Technology utility is mature and
Benefits for 1 resistance to change diminishes
value clinicians and
managers 2
Resistance is minimal and
managerial impact starts to grow
Validation
3 (usability) 3 Managerial impact
1
When effective
change happens?
2
resistance to
change
Technological Technological User Organizational time
change diffusion acceptance change

6. IT Learning curve
Benefits for
value clinicians and
managers
Validation
validation castle
3 (usability)
1
mud
trench
digging
2
resistance to
change
Technological Technological User Organizational time
change diffusion acceptance change

7. Round table questions
a) Has IT significantly transformed healthcare organizations and the
way healthcare is delivered?
b) Does this transformation equally impacted efficiency, quality,
safety, organizational and professional development?
c) Does our education system train the skills needed to profit from
new information and communication technologies?
d) Is the digital revolution in healthcare in an advanced state or it is
just beginning to show up?

8. Warm-up Survey
GOAL To assess:
- ICT impact
- Telemedicine impact
- Resistance to change
- Change management practices
METHODS Online survey
- Gestión Sanitaria LinkedIn Group (300 members)
- Clinical leadership course students (40 members)

9. Respondents
Others
14%
Clinicians
34%
Technologists
24%
No of respondents: 93
Managers
Average age: 42.9 28%

10. Technology impact: EHR
IT impact level IT has hardly
impacted
Professional
Development
24% 27% professional
development
Organizational
46% 6%
Development
High
Patient Safety 49% 9% Medium
Low
Quality 43% 15%
Efficiency 49% 12%
0% 20% 40% 60% 80% 100%

11. Technology impact: telehealth
Telemedicine brings
efficiency in contrast
Telehealth impact level with patient safety
Professional
Development
38% 23% Professional
development
Organizational
Development
53% 14% remains low-impacted
High
Patient Safety 39% 15% Medium
Low
Quality 52% 14%
Efficiency 65% 10%
0% 20% 40% 60% 80% 100%

12. Change resistance
Clinicians are the
Change resistance
most resistants to
90%
82%
change
80%
68%
70% 65%
60%
50% High-resistant
Neutral
40% Low-resistant
30%
20%
10%
0%
Clinicians Managers Technologists

13. Change management
Training remains the
most valued change
management action.
Change management practices
CoPs emerge.
Communities of practice 46% 14%
Communication materials (blog, newsletter) 16% 47%
Online forums 17% 49%
Technical Manuals 12% 64%
Simulation 37% 17%
Decision Support Systems 31% 15%
Training 53% 7%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
More cost-effective Moderate cost-effectiveness Less cost-effective

14. Change management
Benefits for
value clinicians and
managers
Validation
3 (usability)
1
10.5
months Expect almost 1
2
year to see changes!
resistanceto
change
Technological Technological User Organizational time
change diffusion acceptance change

15. Change management
Effective change (in months)
14
11,95
12
10,25
10 9,25
8
6
4
2
0
Clinicians Managers Technologists