Lessons Learned in Organizing Digital Transformation in Dutch Secondary Care: A Qualitative Study (Preprint)

Abstract

The healthcare sector is under significant pressure, with demand outpacing supply and multiple challenges in accessibility, affordability, and quality. The organization of current healthcare systems is unsustainable, exacerbated by labor shortages and escalating expenditures, particularly in Europe and the Netherlands. To address these issues, hospitals are increasingly adopting digital transformation strategies, leveraging technology and data-driven care to ensure the sustainability of healthcare systems. This transition, known as "digital transformation," involves the systematic implementation of digital technologies and processes. Hospitals must integrate digital healthcare seamlessly into existing processes to achieve high-quality hybrid care. However, there is no definitive strategy for implementing these digital transformations.

This study aims to gain insights into how Dutch hospitals organize their digital transformation, the strategies they use, and the lessons learned, to provide recommendations for other hospitals embarking on their digital transformation journeys.

To answer the aforementioned research questions, we conducted a qualitative multicase study. A purposive sampling technique was used to select the participants of this study. A total of 11 hospitals within the Netherlands were invited to participate via an email, which also contained the informed consent. We aimed to include different types of hospitals: University hospitals and general hospitals. General hospitals can be top clinical learning hospitals (STZ) and/or part of the mProve network, an alliance of seven ambitious top clinical hospitals shaping future healthcare.

The aim of this study is to gain insight into how a selection of Dutch hospitals organizes their digital transformations, what strategy is used, what the experiences are and the lessons learned. Although hospitals organize their digital transformation in different ways and with different teams or departments, they all meet similar facilitators and barriers. Inspired by CFIR, the ExpandNet Scaling Up framework and the HHQA, these factors can be categorized as follows: the structure of the digital program; cultural factors within the organization; financial factors internal or external to the organization; political factors internal or external to the organization; patient needs; resources and skills; and technical factors.

Conclusions This study aimed to investigate how hospitals currently organize their digital transformation, their experiences and the barriers and facilitators they encountered within this process. Overall, one can conclude that various approaches are utilized for organizing the digital transformation. However, there are also many similarities between the methods employed by different hospitals.