HealthManagement, Volume 18 - Issue 2, 2018

Deconstruction of business processes to disruption of business models

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How healthcare IT can impact business models. 

What is the potential for information technology to transform healthcare processes and where will the consumer stand?

For more than eleven years, I have been active via the European Association of Hospital Managers (EAHM) as a pro-bono member of the board of ENTSCHEIDERFABRIK. This is the incubator for healthcare digital transformation projects and has the longest track history in Germany. More than 150 projects in information, communication, control, and medical technology have been realised in the ENTSCHEIDERFABRIK ecosystem. They have served to demonstrate the “value contribution” of digital transformation to the success
of organisations.

The 5 key Health ITtopics of the 2017 incuabtor process are:
• Case record plus: new ways in integrated care and patient empowerment
• Increasing patient safety through avoidance of mistaken identities via manual scanning of patients and objects such as drugs, etc.
• Digitisation 4.0: taking delivery of patient data out of Apple HealthKit and Apple CareKit in hospital electronic medical records
• Realisation of a gainful, media-free and legal- secure documentation process with mobile qualified signature
• More time for patients and patient care via meaningful integration of smartphones & tablets in the hospital it environment

The term “value contribution” has positive connotations. In Germany, digital transformation is generally received in a positive way with tens of millions of Germans using a smartphone.


Breaking down business structures

When we take a look at the phrases “from deconstruction of business processes to the disruption of business models”, the perception is fitting in that all this is part of risk communication: what will the effects be of the digital transformation if players do not anticipate, or ideally influence, the changes?

As consumers, we experience what digital disruption means on a daily basis. stakeholders from the German healthcare segment gained insight very clearly during last year’s Entscheider-Eeise (ENTSCHEIDERFABRIK delegation) when they attended the Leadership Summit of the American Hospital Association in San Diego.

The ubiquitous question is, how will the patient and his or her smartphone, the citizen and his individual health record or personal consumer-driven electronic medical record—in interaction with institutional medical records maintained by care providers—change processes and structures? And all this is happening in Germany without regulations of the self-governing body of healthcare institutions playing any kind of a role.

In San Diego, delegates were able to experience how hospital chains and health systems combining care providers and payers with up to 94 providers of individual personal health records interact (in all pre-acute in-house cases, acute care, as well as post-acute care). they were shown how patients were able to access these individual health records using their mobile smartphone apps based on their own requirements and conditions, exchanging data with institutional medical records from hospitals at various stages in their treatment processes.

The value of competition

Tying in with the term risk communication, organisations operating institutional medical records, ie, care providers and payers, should ask themselves whether they are already in a position to interact with individual health records. the questions are in concrete; is there a Health Information Management (HIM) strategy and an IHE-conforming platform in place?

These will enable them to tap efficiency potentials in the organisation of their processes due to interaction between the patient, or data consumer, and his individual health record with the institutional medical record – “Digitisation 4.0”.

In times of limited budgets, HIM is a likely candidate for solving the problem. Strategic HIM is the key to safeguarding revenue. On the one hand, strategic HIM provides a value contribution to the success of the organisation, or a competitive advantage in comparison with competitors who have no adequate response to patients requiring interaction between their personal health record and institutional records—if only at the level of service portals like the booking portal “booking.com”.

On the other hand, it itself is a critical organisation process and a key instrument for business management, categorised as critical infrastructure by the best practices of the German IT Security Law, which therefore requires the protection of IT systems.

As a consequence, this means that the traditional triad enabling success of hospitals —surplus, utilisation, and investments—will no longer be the result of providing quality and efficient care. Furthermore, putting quality and efficiency in the focus will no longer support or enable that triad.

The way forward for healthcare
When we look at risk communication and the phrase “from deconstruction of business processes to the disruption of business models”, the “average citizen” postulated by the statistical yearbook ought to be aware that only those organisations will survive on the market which anticipate, and embrace, the digital transformation.

There are a large number of examples from other sec tors of the economy. In tourism , newspaper publishing, retail, and further segments, large-scale transformations have taken place. Are hospitals really
so much different from a railway or an airline?

People check in via an app as passengers—and they come “on board”. This means they become an essential part of the information management of the respective organisation, and they take on tasks previously carried out manually by staff of the organisation.

Is there still anyone who remembers how these organisations functioned without the significant collaboration of the passengers or other types of consumers with regard to interaction and the exchange of information? Do you or your children still remember paper airline tickets?


The new triad therefore has to be on a footing of Quality, Health Information Exchange (HIE), and digitisation-derived financing models such as “Pay for Quality, Performance, etc.” it places the consumer, the citizen, health policyholder and patient driving digitisation in focus. The consumer will be the decisive factor for the success of health organisations.


Key points

  • ENTSCHEIDERFABRIK has incubated 150 healthcare digital transformation projects
  • Consumers understand daily the meaning of digital disruption
  • Healthcare digital transformation is occurring in Germany without involvement of the self-governing body of healthcare institutions
  • A recurring question is where is a Health Information Management (HIM) strategy and IHE conforming platform?
  • The medical record – “Digitisation 4.0” will support efficiency potential in processes
  • German IT Security law requires protection of IT systems meaning the traditional triad of surplus, utilisation, and investments will no longer the outcome quality care provision
  • Early digital transformation adopter organisations will be market survivors
  • This has already been seen in retail, hospitality and media sectors
  • A new triad should be based on Quality, Health Information Exchange (HIE) placing the consumer/ patient centrally




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