Paths to a Digital Strategy in Hospitals

The Federal Social Security Office is supporting hospitals across Germany during the digitalization of their processes in the form of measures pursuant to the Future of Hospitals Act (Krankenhauszukunftsgesetz; KHZG). The deadline for submission of applications for funding expired at the end of 2021, and now initial successes in the realization of the measures such as can be seen at the Vestische Kinder- und Jugendklinik Datteln are becoming apparent. During an interview with Detecon experts Matthias Hemmes and Benedikt Thiessen, Daniela Aufermann, chief digital officer of the clinic, explains how digitalization has been driven forward at her facility and the key role played by strategic issues in the process.

What do you consider to be the greatest challenges in the hospital sector at the moment, and how does digitalization aid in mastering them?

The most serious challenges are certainly the rising energy costs and the shortage of skilled workers; the latter issue is being exacerbated by the imminent retirement of the baby boomers. Since a hospital is a personnel-intensive service facility, digitalization can help to render the enormous cost factor of personnel manageable, although this also requires investment in some cases. For instance, processes can be supported by technology and personnel assignments can be scheduled more efficiently — leaving in turn more time for what is really our core business: people.

What is the status of current KHZG projects in your company?

Here at Vestische Caritas-Klinken GmbH, we are presently implementing a total of four of the funding measures subject to sanctions included in the KHZG; we have been granted funding for three of these measures while the fifth has already been implemented.2 They include, first and foremost, Funding Measure 2, the so-called patient portal, which will enable us to present ourselves as an organization and actively to involve patients in the decisions about their treatment. Funding Measure 3, digital care and treatment documentation, has already been partially implemented. Application has been submitted for the decision support system of Funding Measure 4, and a patient data management system (PDMS) has already been introduced. We are planning to introduce an additional PDM system in pediatrics. However, we place particular importance on Funding Measure 10, IT security. This will enable us to modernize and expand the network infrastructure, including servers and switches, to ensure a high standard of security.

The realization of these funding measures is closely linked to digitalization issues that require a strategic approach. How have you proceeded in your facility in this regard?

We have developed a digital strategy that covers three major fields of action: first, the clinical operation, i.e., all clinical processes for the improvement of care and the reduction of the workload for employees. A second field is the digitalization of administration. The focus here was above all on the introduction of digital processes to increase efficiency and quality, reduce costs, and ease the workload on employees. Last, but not least, we looked at the technology — specifically, the planning and modernization of the technical infrastructure with respect to hardware and software for employees and patients.

How did you develop your digital strategy, and what stakeholders were involved?

We initially oriented our actions to the overarching mission statement of the Vestische Caritas-Kliniken, the requirements of the KHZG funding, the medical strategy, and the strategies of other competitors. In addition, we derived framework conditions from our own corporate strategy and held discussions on the future development of the clinic with the pertinent stakeholders in our facility — from management to senior physicians to IT.

From this starting point, we identified essential projects, prioritized them according to urgency and importance, and ordered them in a logical structure. Our digital strategy was the result. It presents the specifics of the future strategic direction of the facility, including a detailed road map for implementation placing heightened attention on project and knowledge management, change management, and employee communication.

The focus was on employees and patients. In the past, people in particular were often neglected, and the focus was too one-sided, namely, on the care mandate and the associated billing.

I hear an implication that the role of culture was by no means a negligible one in your endeavors — is that right?

That is very true. Cultural change was — and still is — an important subject that has impacted many areas.

Many employees, especially those working in smaller hospitals and who were trained in the 1980s or 1990s, have had little experience in the use of technology and even now work largely with analog methods. Our awareness of this fact has prompted us to place high value on communication, information dissemination, and knowledge management and to offer training in the use of technology so that employees gain an understanding of the nature of their daily work in a highly technological environment.

To what extent does the digital strategy interact with other strategic elements such as the medical strategy, the data strategy, or the overarching corporate strategy?

The corporate strategy must, of course, serve as the guiding principle for all digitalization efforts. In view of the care mandate, the medical strategy should always be included. Both strategies clearly lead the way forward in this sense while other strategies, such as IT and data strategy, tend to be more of contributors.

We do not have a dedicated, written medical strategy at the Vestische Kinder- und Jugendklinik Datteln. Should a new field of service (surgery, for instance) be offered at the hospital in the future, the digital strategy would have to be given full consideration during its integration. It would have to demonstrate how such a service can benefit from digitalization. Beyond this, we have only a rough IT strategy, which is also part of our digital strategy. The data strategy has so far been considered solely in the form of key points in the IT strategy.

In conclusion, how would you summarize the goals and functions that a digitalization strategy should ideally achieve?

The digitalization strategy is always a sub-strategy of the corporate strategy and should always focus on patient needs and respond to the users. In general, people, whether employees or patients, should be given more consideration in all our strategies, especially in the digital strategy and IT strategy. IT measures in particular often forgot about people in the past. The primary focus here has been primarily on the care mandate and the associated billing. That needs to change.

Daniela Aufermann is currently chief digital officer (CDO) at the Vestische Kinder- und Jugendklinik and has had extensive experience in managing IT and organizational projects in the health care sector and the digitalization of hospitals. She studied medical informatics, biomedical management and marketing. In addition, she is the honorary director of the “Digitalization and Process Development in Hospitals” section of the association Purpose:Health e.V.