How Spitex is becoming all-round digital – a pilot project by Spitex and BFH
Spitex Bern has launched a pilot project together with the Bern University of Applied Sciences (BFH): Over a period of four years, the Spitex organisation is undergoing a comprehensive digital transformation, closely accompanied by scientific research.
Swiss companies must adapt to the megatrend of digitalisation in order to remain competitive and fit for the future. This was the conclusion of a study by Deloitte ¹ five years ago. in 2018, the Board of Directors of Spitex Bern set digitalisation as a key strategic goal, and the “Digital Transformation ² of Spitex Bern” project got underway. “Through this, we want to become an even more attractive employer, remain the market leader in the Bern area – and make our processes even more efficient, which is particularly important in times of pressure to save money and a shortage of skilled workers. And we want to offer our 1400 clients more transparency and an even better quality of care,” explains Judith Liechti, Head of Service and Deputy Managing Director. Since 2019, she has been the overall project manager for the digitalisation strategy of Spitex Bern with its 400 employees. At that time, the project team was looking for scientific support for the project – and found Prof. Dr. Friederike J.S. Thilo, experienced nursing specialist, PhD in nursing science and head of the innovation field “Digital Health” at the Bern University of Applied Sciences (BFH).
Under the direction of Friederike Thilo, in cooperation with Prof. Dr. Reinhard Riedl from the Department of Economics, BFH is not only taking care of the accompanying evaluation of the digital transformation as part of the “TALE” project, it is also actively shaping it. “We understand Change date and time our work as coaching and monitoring. And we complement the great nursing knowledge of Spitex Bern with our knowledge from health research, science, business and other digital transformations,” says Friederike Thilo. As a first step, the researchers conducted an analysis of the current state of digitalisation and technologisation at Spitex Bern in 2019 and 2020. Based on the one-year study, which was financed through research funds, the digitalisation strategy of Spitex Bern was developed – and the four-year pilot project could start in autumn 2021.
Digitisation steps taken
To date, Spitex Bern has realised the following central sub-projects:
- Digital data only: All client data has been digitised, whereby, according to Judith Liechti, the focus is on the security of sensitive data. Documents such as guidelines are also available digitally, for example through a hygiene app on all work tablets.
- Client portal: At the heart of the digital transformation is a new digital client portal, where clients or relatives can log in via the app OXOA. “They can then see, for example, when they are being visited by which Spitex staff member,” explains Judith Liechti. This gives all users a simple overview of the work of Spitex Bern – anytime and anywhere. The app will be tested from January 2023 and can be used by other non-profit Spitex organisations from the second quarter of 2023. “All new digital offers are an addition for the clients, not a compulsion,” clarifies Friederike Thilo. For example, from January 2023, communication via OXOA will also be possible (see info box) – but this does not mean that “old” communication channels such as the telephone may no longer be used.
- Personnel process: From February 2023, the entire personnel process – from the application to the conclusion of the employment relationship – will take place digitally. As early as the end of 2022, all employees will have access to the Abacus software, which they can use, for example, to view their salary payments via an app. In addition, an online solution is currently being introduced that will allow all employees to register for further training.
- Warehouse management: Spitex Bern has started a pilot project with digital scales in the material warehouses at two locations. The scales recognise when a product is running low. Then, depending on the product category, they inform a responsible person or trigger an automatic ordering process. QR codes on the products further facilitate warehouse management. “Thanks to digitalisation, this management can be done with a click, so to speak, which saves us valuable human resources,” says Judith Liechti.
- Landing page and website: At the beginning of November 2022, Spitex Bern launched a recruitment campaign. “If a Spitex organisation offers comprehensive digital working tools, it must also communicate this to the outside world,” says Friederike Thilo. “And an organisation cannot boast about its digitalisation and present outdated online presences,” adds Judith Liechti. A new landing page was therefore created for the campaign, and a new website will follow in spring 2023.
- 24/7 IT support: Spitex Bern’s IT support is available around the clock, even at weekends. In the future, Spitex Bern wants to offer this support together with other Spitex organisations in order to make use of synergies. Discussions are underway in this regard.
- Integrated care: In order to improve transition management, Spitex Bern has helped to develop OPAN Spitex in the past. Now OXOA is to further improve interprofessional cooperation by allowing other service providers to use the portal in the future – provided the client gives his or her consent. Spitex Bern is holding initial talks with partner organisations for this purpose. In addition, in 2023 it will participate in a pilot project for the implementation of SHIP (“Swiss Health Information Processing”) with Spitex Basel and the health insurers Sympany and Helsana. SHIP is intended to ensure simple digital exchange of demand reports, especially between care and the health insurers.
- Data use and analysis: According to Friederike Thilo, BFH wants to achieve “that Spitex Bern better evaluates and uses its daily collected data step by step, among other things for strategic decisions and the optimisation of the care process”. In this way, Spitex Bern would know, for example, who its clients are exactly – and what qualifications the Spitex employees consequently need in order to ensure optimal care for all client groups.³
Further sub-projects are already being considered. According to Friederike Thilo, in the third year of the project, it should be possible to introduce “tele-care”: Care and support that can be provided at a distance thanks to digital aids such as sensors (see report on this in “Spitex Magazin” 6/2022; p. 30).
The ingredients for a recipe for success
According to Spitex Bern, the following aspects must be taken into account for a digital transformation to succeed:
- Participation: It is not only the board of directors and management that need to be behind a digital strategy, says Judith Liechti: “If the staff does not join in, the transformation will not succeed.” According to the Deloitte study, it may take a change in corporate culture for employees to develop a “passionate pioneering culture” with regard to digitalisation. “Our employees have demonstrated a great pioneering spirit for decades,” assures Judith Liechti. Nevertheless, it will always be a challenge to inspire all employees for digital innovations.
- Internal communication: In order to master this challenge, the project team must, according to Friederike Thilo, “maintain the discourse about the benefits of a tool Accordingly, targeted internal communication is the be-all and end-all. The project group communicates, for example, via the intranet, a newsletter and personally in team meetings. The approximately 50 members of the project’s various working groups are also committed to the innovations.
- Reflective approach: Furthermore, the tools introduced must meet the needs and requirements of the employees. To guarantee practical relevance, BFH evaluates data from the nursing process as well as staff surveys. “We first want to understand the problem in practice and only then look for a digital solution,” says Friederike Thilo.
- Support for staff: “All staff must be given the time and support they need to master a new tool,” emphasises Judith Liechti. In addition, training must be practical. “That’s why, for example, all our IT contact persons have a nursing background.”
- Small steps and “quickwins”: Friederike Thilo says that it is important to take an agile approach to digitalisation and to take small steps. This enables “quick wins”, i.e. rapid successes that strengthen the trust of employees and financiers in the project as a whole. Successes should also be celebrated as a team.
- Positive error culture: According to the Deloitte study, digital experimentation and failure can move a company forward – as long as it learns from its mistakes. “We promote an open error culture, in which the search is not for guilty parties, but for insights from mistakes,” confirms Friederike Thilo.
- Ongoing evaluation: BFH ensures that targeted steps of the digital transformation are reviewed according to scientific criteria. For this purpose, feedback from the teams is collected on an ongoing basis, but BFH also conducts systematic evaluations on a regular basis.
- Data protection: Digital innovations are subject to strict data protection guidelines (see “Spitex Magazin” 4/2022). “This is the case with us. For example, we had a data protection expert clarify from front to back that the data on our client portal is secure,” assures Judith Liechti.
The benefits of digitalisation
The clients of Spitex Bern benefit directly or indirectly from all sub-projects, say those responsible. “For example, the digital tools support and relieve our employees. This allows them to concentrate more on their core competence: the care and support of their clients,” explains Judith Liechti. They also agree with the numerous experts who point to the considerable cost reduction of successful digitalisation. “If we calculate, for example, how many hours of administrative work we save through digitalisation, our investment is certainly worthwhile,” says Judith Liechti. Another important benefit of the digital transformation is the improvement of integrated care: If, in future, service providers such as pharmacies, the Pro Senectute or GP practices also communicate and exchange data via OXOA, this will significantly improve interprofessional cooperation and lead to greater patient safety. Should the electronic patient dossier (EPD) become established one day, OXOA should also be compatible with it. However, what often stands in the way of the digitalisation of integrated care is the lack of interoperability of the various systems in the health system, says Friederike Thilo. “We need the will of all the players involved to ensure that the systems communicate with each other in a meaningful and efficient way in the future.”
Finally, according to the two experts, Spitex Bern itself needs something above all to ensure that the digital transformation continues to progress successfully: Agility. “In the rapidly changing digital world, a Spitex organisation must be ready at all times to let go of what has gone before and adapt to current developments,” says Judith Liechti. “Otherwise it has no future
The client portal of Spitex Bern
Spitex Bern developed a concept for a digital customer portal in the current year. In August 2022, the board of directors decided on the OXOA Mobile App as the associated web application. OXOA is a product of AvanzaTec GmbH, which was founded by developers of root-service AG. Spitex Bern obtains the Perigon software from the latter. According to AvanzaTec, the app can also be used without Perigon. “Via OXOA, clients or relatives can view the upcoming Spitex assignments and the responsible employees, and if desired, also the progress report and the medication to be taken,” explains project manager Gabi Kundert. The portal also allows access to several client profiles through one log-in. In addition, Spitex can disseminate information via it, and at the beginning of 2023, communication via the app will be possible, such as rescheduling or cancelling Spitex appointments. In the future, OXOA will also display the vital data of clients, contain documents and serve as a tool for telemedicine as well as an interprofessional communication and information portal. This will be done by sharing it with other actors in health care. The clients’ data sovereignty and a high level of data protection are guaranteed.
OXOA will soon be tested and optimised in a pilot project. In the second quarter of 2023, the portal will be transferred to regular operation and will be available to other non-profit Spitex organisations at an attractive price. “Each Spitex organisation decides for itself which functions of the portal it wants to activate,” says Gabi Kundert. Judith Liechti, overall project manager of the digital strategy of Spitex Bern, will be happy to provide interested Spitex organisations with more detailed information: firstname.lastname@example.org
- The study by the Swiss auditing and consulting firm Deloitte “Digital Future Capability. How do companies prepare for the opportunities and challenges of digitalisation?” was conducted with 50 companies in 2016 and 2017.
- The Bern University of Applied Sciences (BFH) defines “digital transformation”, following Cheng Gong and Vincent Ribiere 2020, as a “fundamental change process enabled by digital technologies that aims to create radical improvements and innovations for an entity to create value for its stakeholders through the strategic use of its key resources and capabilities”.
- The topic of “data and data use in Spitex” will be addressed in more detail in “Spitex Magazin” 5/2023.
This article first appeared in the December issue of Spitex Magazine: Spitex Magazine 6/2022