Professional article: Strategies for digitalization in the healthcare sector

The digital transformation in the healthcare sector is picking up speed - perhaps too slowly for many. Nevertheless, government subsidies such as the German Hospital Future Act and the Hospital Structure Fund, as well as legal provisions such as the E-Health Act, are boosting digital expansion in clinics, care facilities and medical practices. The goal of the funding programs is to lower the barriers to digitalization from the operator's perspective, and create incentives to invest in software, hardware, specialists and expertise. The funding is about making patient data is always accessible when it is needed. Such a consistent expansion of the digital infrastructure is necessary to ensure sufficiently good patient care. At the same time, cross-institutional processing of sensitive data via distributed systems increases the need for IT and information security. In this context, the IT architecture and the service desk have a special responsibility.

On the way to a modern healthcare system, the reliability of the IT department must therefore be promoted in the best possible way. The IT infrastructure forms the foundation for the electronic doctor's letter and the electronic patient file, among other documents. However, digital health and care applications are also dependent on reliable IT systems. A correspondingly high priority should be placed on the IT department and thus on the topic of IT service management (ITSM). Due to the widely perceived shortage of skilled workers in IT and care professions, efficiency is a key issue. Only with an increase in performance can IT systems be managed as smoothly as possible and made available to employees, partners, suppliers and external service providers of the respective medical facility. In addition to protecting sensitive information, the primary goal is to save working time for administrative activities, which can then be spent on patient care and treatment. This also includes communication with external partners and service providers.

The integration of systems increases both the need for IT security and the necessary application expertise. The immense turnover in healthcare facilities has made them more attractive for cybersecurity attacks and data theft. In addition, a higher degree of digitalization increases the risks of disruptions, system failures, application errors and the general effort involved in the administration of IT services.

It is important to ensure that all services are easily accessible for the respective target group (doctors, nursing staff, students, etc.). It must be possible to create a ticket - whether IT-related or not - easily and in just a few clicks. The same applies to external services outside of actual patient treatment and care: the easier it is to “order” a requirement, the more the workload on specialist staff is reduced. The primary goal must be to ensure that all digital services are as accessible and functional as possible.

Services that are provided internally and externally must be made easier, not more complicated, through digitalization. In order to achieve this, the software used must fulfill a number of requirements so that it can provide real relief in hospital and care operations. A self-service portal offers numerous advantages here. A self-service portal is usually started via a normal internet browser with individual (guest) access data. It acts as a central hub for all services that are offered and provided in an organization. Usually, list and tile views are combined with shortcut bars and search and filter options so that desired services can be found quickly and used easily. The requests are then processed in the backend by the relevant specialist departments, service providers, suppliers and partner companies.

• Central and straightforward access to all available services of a facility (“single point of contact”)

• Available around the clock (reporting incidents, requesting services, placing orders with external service providers)

• Base filters and role concepts for greater usability, as only relevant and approved services are displayed

• Mobile use in the browser without installation and maintenance for end users

• Any expansion of the service portfolio (other departments, external partners, etc.)

A self-service portal can help. Even if a feature-rich self-service portal is not (yet) on the wish list for most institutions, as they are only looking for an ITSM tool, for example, the long-term goals should definitely be taken into account when choosing software. As mentioned above, IT service management forms the foundation for all other services. Ideally, the manufacturer has already gained experience in the implementation of self-service portals. Sustainability is the keyword of the hour when it comes to securing long-term profitability. Every tool change costs money; it is therefore important that all short-, medium- and long-term requirements are considered when defining the requirements. Interface integration, update capability and long-term support from the manufacturer must always be evaluated.

The tool should also be able to evaluate assets in order to assess the protection requirements of information and derive appropriate protective measures. A flexible CMDB supports this and serves as a solid basis, but it does not replace asset management. Determining the protection requirements of information values (= assets) is relevant, for example, if an ISMS in accordance with ISO 27001 is required.

Specifically, the following technical features help to reduce the workload of service desks and other service providers:

• Automation of repetitive, administrative tasks via standardized process chains that require little or no human interaction (controlling licenses, approval and release procedures or BPMN tasks)
• Status management for better resource planning and prioritization as well as greater transparency
• Use of AI for assigning ticket categories, reading relevant information and suggesting solutions from knowledge database entries
• Structured digital forms with targeted information queries for fewer callbacks
• Automated billing and documentation of services rendered
• Fast and efficient configuration via low-code elements
• Integration of third-party systems via interfaces so that tool changes are no longer necessary

Digital transformation is a process in which not all steps can take place at the same time. On the one hand, implementing and customizing software takes time. Features must be individually adapted to the respective institution, tested and consolidated in the application—existing systems must be integrated via interfaces and databases migrated. End users also have to get used to operating with new tools. The IT landscape is expanded step by step, starting with the IT department and ensuring that service requests and IT-related incidents can be responded to quickly and with the desired quality. As soon as IT service management is running reliably, the service mesh offered can be woven more tightly. This is because the concept of request, categorization, order placement, assignment, completion and billing can also be applied to services outside of IT, so that services other than the IT department can also be offered throughout the organization via a self-service portal.

The internationally recognized best practice catalog ITIL contains the guiding principle: “Start where you are”—which roughly means that every tool must fit into an existing software landscape with a specific context—and never on a so-called “greenfield site”. The challenge now is to make the best possible use of existing resources, know-how, legacy systems, etc., and to get the most out of them under the given circumstances. It is important to start with customizable, future-proof service management software and not lose sight of the overarching goal.

As soon as a self-service portal for IT matters has been implemented, further functions can be added (via additional function tiles and intelligent search parameters). This allows external service providers or other functional groups and task areas (HR, sterilization, OR, laundry, laboratories, technology, etc.) as well as stakeholders (students at university hospitals, partners, suppliers) to be integrated into the self-service portal. A flexibly expandable self-service portal is the key factor for efficiency, sustainability and future viability. The more smoothly these services are offered, carried out and optimized, the more time remains for the core business—the care and treatment of patients. This efficiency is necessary to ensure long-term sustainability.