Sustainable digitalisation – new roles for health professionals
Digitalisation in the health sector is advancing. The early involvement and sustainable support of healthcare professionals are fundamental in this process. New fields of action and patient needs require new roles, be it technical support in the team or smart advice at the bedside. Healthcare Information Technology (HIT) is increasingly being promoted as a solution for improving work processes and increasing the quality of care in the healthcare sector. The expected benefits lead to an increase in digital transformation. In an international comparison, however, Switzerland is lagging far behind. According to a report by the Bertelsmann Foundation, the Swiss healthcare system is currently in 14th place in a comparison of countries in terms of digitalisation. Due to political pressure (introduction of the EPD) and the proliferation of digital solutions (e.g. 250,000 health apps), increased digitalisation in the Swiss healthcare system can be expected in the coming years. In addition to the financial resources required on the part of the organisation, this also has direct consequences for healthcare staff. However, compared to other sectors, healthcare professionals are unlikely to be replaced by technology. It is therefore obvious that, apart from radiology specialists, there is basically no fear of losing one’s job due to technology, as the latest figures from the STRAIN study show. Digitalisation goes hand in hand with new or expanded competences and roles. In order to make the process successful in the long term, progress at the personnel level is therefore fundamental in addition to technical progress. If health staff are not involved or their roles are not clarified, this can lead to “technostress“. Technostress is an expression of one’s own dissatisfaction, fear, tension and anxiety when interacting with technology. A current example is the introduction of the hospital information system (HIS) “Lukis” at the Lucerne Cantonal Hospital, which led to an increase in stress, at least temporarily. HIS in particular are a double-edged sword in this respect. On the one hand, the use of an HIS can lead to a visible increase in revenue by accelerating processes and improve the quality of care. On the other hand, the implementation of an HIS can be accompanied by an increase in the burden on health professionals. In order to avoid this undesirable effect of digitisation, three approaches seem to be relevant that have a direct impact on the role of health professionals:
1. Early involvement of health professionals in the development and implementation of HIT
Up to now, health professionals have been involved too late(usually only during implementation). This leads to poor usability and missing interfaces. Involving health professionals also changes their role. The staff thus changes from consumers to co-producers. At the same time, this change promotes digital literacy, because it enables health professionals to deal with information technology and to develop a better understanding of the abstract processes inside hardware and software.
2. Improving the digital competence of health professionals
Digitalisation requires new or enhanced competencies. There are a variety of efforts to define digital competences. Basically, the digital competences for health professionals can be said to consist of the necessary knowledge, the required skills, ethical considerations and the corresponding personal attitude towards technology. In terms of content, the most widely used are the recommended 24 core competencies of the Tiger Initiative. These recommendations provide a clear framework and enable education and training for health professionals to be developed and delivered in a targeted way. For example, the introduction of the EPD has great potential in terms ofshared decision making. However, health professionals need the necessary skills to 1. be able to use the technology and 2. train patients to be able to interact with it together.
3. Continuous support (content and technical)
When new technologies are implemented, health professionals are trained to use them. Most of the time it remains a one-time training, but especially the continuous support by the in-house informatics as well as in the team is fundamental for a successful and sustainable use of new technologies. Here, too, new roles can be formed so that a health professional has extended competences in relation to implemented HIT and supports his or her own team.