Digital disruption ‘syndromes’ in a hospital: important considerations for the quality and safety of patient care during rapid digital transformation

Abstract

The digital transformation of hospitals in Australia is occurring rapidly in order to facilitate innovation and improve efficiency. Rapid transformation can cause temporary disruption of hospital workflows and staff as processes are adapted to the new digital workflows. The aim of this paper is to outline various types of digital disruption and some strategies for effective management. A large tertiary university hospital recently underwent a rapid, successful roll-out of an integrated electronic medical record (EMR). We observed this transformation and propose several digital disruption “syndromes” to assist with understanding and management during digital transformation: digital deceleration, digital transparency, digital hypervigilance, data discordance, digital churn and post-digital ‘depression’. These ‘syndromes’ are defined and discussed in detail. Successful management of this temporary digital disruption is important to ensure a successful transition to a digital platform. What is known about this topic? Digital disruption is defined as the changes facilitated by digital technologies that occur at a pace and magnitude that disrupt established ways of value creation, social interactions, doing business and more generally our thinking. Increasing numbers of Australian hospitals are implementing digital solutions to replace traditional paper-based systems for patient care in order to create opportunities for improved care and efficiencies. Such large scale change has the potential to create transient disruption to workflows and staff. Managing this temporary disruption effectively is an important factor in the successful implementation of an EMR. What does this paper add? A large tertiary university hospital recently underwent a successful rapid roll-out of an integrated electronic medical record (EMR) to become Australia’s largest digital hospital over a 3-week period. We observed and assisted with the management of several cultural, behavioural and operational forms of digital disruption which lead us to propose some digital disruption ‘syndromes’. The definition and management of these ‘syndromes’ are discussed in detail. What are the implications for practitioners? Minimising the temporary effects of digital disruption in hospitals requires an understanding that these digital ‘syndromes’ are to be expected and actively managed during large-scale transformation.