The Journal of mHealth Vol 1 Issue 3 (June 2014) - Page 42

A Clinician's Guide: How to Enhance Adoption and Diffusion... A Clinician’s Guide: How to Enhance Adoption and Diffusion of Technology in Healthcare By Dr Alexander Graham Healthcare provision across the world faces unprecedented challenges in the modern day, with spiralling costs, aging populations and political pressures impacting on the quality and quantity of care given. As a result, front-line staff are consistently being asked to do more with less. Having practiced as a doctor in the UK, I have seen the relationship first hand between healthcare professionals and technology. My anecdotal view, in the years I spent as a student and doctor, is that the vast majority of technology hinders rather than helps clinicians in their day-to-day work. But we have the technology to put a man on the moon so why can’t we reliably improve workflow, communication and outcomes in hospitals and clinics? Why is healthcare as a system so reticent to accept new technologies that could improve workers’ conditions and improve patients’ lives? The answer is unfortunately a complex one with many precipitating factors but if technology companies can understand some of the main barriers to adoption and diffusion then they can mitigate them with a bespoke approach. It is possible to write whole books on this topic but I shall concentrate on what I feel are the three main barriers: culture, workflow and staff heterogeneity. CULTURE Healthcare professionals are frequently bombarded with sales pitches from a range of salespeople, from drug reps to device manufacturers to IT professionals, often with a hard-selling, non-userfocused manner. The default setting amongst an increasing majority of clinicians as a result of this is scepticism and disenchantment (sometimes referred to as ‘innovation fatigue’) such that when the next painkiller, hip replacement or software innovation comes along, sellers will often start very much on 40 June 2014 the back foot, even if the product or service is of high quality. This means that the ‘pre-sales’ process for technology is critical. Sellers need to make a conscious and sustained effort to develop personal relationships with the people who will not only be their end users but should become their clinical champions in terms of driving forward procurement and then adoption and diffusion. Senior clinicians will often sit on the board of directors in hospitals and assist in procurement of new technologies so this is a remarkably important step. WORKFLOW The representation of the day-to-day lives of doctors, nurses and other healthcare professionals in the media and by the general public is unfortunately often far from the truth. It is impossible to explain the workflow patterns of clinicians if you have not worked in a hospital or at least spent an extended amount of time in clinical care before. Technology will never be diffused within a healthcare system if it is not intuitive, easy to use and at least contributes to making the day-to-day lives of professionals easier. To give you an idea of the scale of some of the pressures that workers can be put under, consider how a hospital operates over a weekend. It is regularly expected that 2-4 doctors will be looking after somewhere in the region of 400 patients, with the number of daily tasks (blood result checking, ordering scans, reviewing patients) in the hundreds. If you have a device or software platform that requires excessive time to use or creates superfluous data, it is unlikely to last much past the first trial. By walking the walk of your target market, you will find numerous reflection points and nuances in the system that you must use in either developing or refining your product or service. By overcoming these mini-hurdles, end-user engagement will be that much greater. STAFF HETEROGENEITY Analysing the workflow patterns of your target market will hopefully help assist in the realisation that you cannot group all doctors or all nurses in one homogenous group. The work of an emergency consultant compared to an orthopaedic surgeon or the work of a ward nurse to a nurse consultant will be virtually incomparable with different working patterns, environments and stakeholder interactions present. As a result it is imperative to build in flexibility to your product or service such that individuals’ concerns, ideas and differences can be allowed for. One of the most successful companies I have seen recently has a fully bespoke software application for patient data gathering so each department or professional can tailor the interface to their exact requirements rather than having a top-down implementation. Flexibility in your product will generate a much larger potential user base. CONCLUSION If you do not have a bridge between the technology that is being produced and the end-users on the front line, then your products and services will never reach their potential. Fully understanding the environments in which your target markets operate is crucial to any commercial success and imperative for companies to understand. Dr Alex Graham is a medical doctor by background, having trained in London before entering the business world. He is currently a founding partner at AbedGraham, a research and strategy consultancy which assists global IT corporates to navigate the clinical, organisational and commercial complexities of the UK’s National Health Service (NHS). n