The first step towards a digital transformation isn’t to adopt new technology. To truly transform, healthcare organizations need to first deal with legacy thinking, legacy culture, and legacy processes that surround legacy technology. Get that right and the road to transformation becomes faster and smoother.
Healthcare IT Today recently had the opportunity to discuss the topic of legacy in healthcare organizations with Lisa Esch, Chief of Strategy, Innovation and Provider Industry Solutions at NTT DATA Services.
Legacy is more than technology
Right off the bat, Esch expanded what the term legacy really means: “When we think about healthcare and just even the business of healthcare, there is a lot of legacy there. There’s tradition, there’s legacy systems, and there’s processes. Legacy is more than just IT systems. It’s the people. It’s the culture.”
Consider, for example, the process around assessing the cybersecurity risk of vendors. When Ransomware was only something out of a Hollywood movie script, healthcare organizations would occasionally do an assessment, usually when a contract was about to expire. That approach clearly needs to change given the cyber reality of today’s operating environment.
In a similar vein, the way healthcare IT departments attract talent needs to change. Most will simply post a job on their website or LinkedIn and then hope candidates will apply. That’s legacy thinking. Organizations need to be more proactive and aggressive. They need to collaborate on internships with local high schools and colleges or at the very least having current team members go there to talk about the amazing career they could have in healthcare. They need to hold hackathons, create videos for social media that show how fulfilling healthcare careers can be (ie: how it helps the community).
In order to truly transform, healthcare organizations need to address their legacy.
Dealing with Legacy
Why is it important to address legacy in healthcare? Esch put it succinctly: “We want this rapid digitization of healthcare, but what is lurking at the bottom and dragging all this down is the legacy. If we don’t address modernizing the legacy in healthcare, it will be very difficult to get a unified digital experience, a unified patient and clinician experience.”
Esch suggests that IT leaders start by taking inventory of their current systems, then look at the corresponding process for updating/maintaining those systems. If any of those are older than five years, they should be flagged for further investigation. It may turn out that those legacy systems are still useful, and all that is required is a refresh of the maintenance program…or it may turn out that the system can be completely replaced by a different application already in place.
Armed with an accurate system and process inventory, IT leaders can then “take a step back and make sure that their forward direction and strategy is still aligned to the organization’s goals” according to Esch.
Digital Transformation vs Modernization
One very intriguing thought put forward by Esch is that healthcare may be chasing the wrong unicorn. Instead of trying to transform, perhaps the goal ought to be modernization.
“Digital transformation is a buzzword,” explained Esch. ”Everyone is talking about it but not everybody knows really where it’s taking them. Modernization is a much broader term and more appropriate as a place to start rather than just following the buzz with digital. We have to modernize the culture, the processes, how we work, where we work, what we do, the infrastructure that supports that – all those things.”
“There are a lot of bright, shiny objects out there right now and it’s really important to just take a step back and breathe,” continued Esch. “Don’t be distracted. Have that strategy, have a framework to make decisions, have a partner that can help you is key.”
Personally, I prefer the term modernization. It is more tangible. Transformation implies becoming something completely new and different. A laudable goal, but it can lead to disastrous investments in shiny objects vs things that will actually move the needle.
Watch the full interview with Lisa Esch.
Learn more about NTT DATA Services: https://us.nttdata.com/en/industries/healthcare-and-life-sciences
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Transcript
[00:00:09] Colin Hung: Hi, I’m Colin Hung with Healthcare IT Today and I’m sitting down once again with Lisa Esch, Chief of Strategy, Innovation and Provider Industry Solutions at NTT DATA Services. Lisa welcome back to the program.
[00:00:27] Lisa Esch: Thank you, Colin. It’s great to be here.
[00:00:30] Colin Hung: So today we’re going to be talking about the challenge of legacy processes, legacy thinking, and legacy culture in healthcare. I’m excited for this topic Lisa.
[00:00:38] Lisa Esch: Me too.
[00:00:39] Colin Hung: So when we use the word “legacy” in healthcare, I personally think of legacy hardware and software, at least I did. But you would say that’s actually too narrow of a definition and you want us to realize there’s a lot more other legacy stuff in healthcare.
[00:00:56] Lisa Esch: Yeah. When we think about healthcare and just event the business of healthcare, there is a lot of legacy there. There’s tradition, there’s legacy systems, and there’s processes. And if we narrow the definition just to technology and just that piece…it’s really hard to modernize.
[00:01:14] Legacy is more than just IT systems. It really is. It’s the people. It’s the culture. It’s supporting the transformation that we’re seeing. It’s much broader than just the systems that support us in health.
[00:01:28] Colin Hung: So Lisa, why is it so important for healthcare leaders to deal with all this legacy stuff?
[00:01:33] Lisa Esch: Because we want this rapid digitization of healthcare today, but what’s lurking at the bottom and dragging all this down is the legacy systems. It could be the people, the process, the culture, the technology. If we don’t address modernizing the legacy systems in healthcare, it will be very difficult to get a unified digital experience, a unified patient experience, a clinicians’ experience. Digital technology that can then can be very disruptive and not helpful in the organization as we move into a more digital ecosystem.
[00:02:09] Colin Hung: There’s a word I want to pick up on that you just said at the top. You said “digital transformation”. I know. Before we got on camera, you were telling me that we’ve put a little bit too much emphasis on digital transformation and not enough on healthcare modernization. What do you mean by that?
[00:02:27] Lisa Esch: Well, digital transformation is a buzzword. Everyone is talking about it, but not everybody knows really where it’s taking them. But if we start with a modernization strategy, you can then really put a roadmap together for this transformation that’s happening in the organization. And you can address the aging systems, the people that support those systems that are aging out and retiring. It’s forcing us into these discussions that really require some thought on how are we going to modernize that?
[00:03:00] Modernization is a much broader term and more appropriate as a place to start rather than just following the buzz with digital. We have to modernize the culture, the processes, how we work, where we work, what we do, the infrastructure that supports that – all those things that come along with that.
[00:03:21] It starts with a strategy. You have to have a modernization strategy because going too fast with the digital components and buying digital applications that the legacy systems can’t support will create some tension in the organization. And you won’t see the results that you should see.
[00:03:39] Colin Hung: I agree. with you because digital transformation to me, conjures up an image of moving from analog to digital, but modernization could mean: you can just improve your analog process because in some cases that actually may be the best. You may not have to invest to digitize it. And in fact, you may harm it by digitizing it too soon. So I like that term. I like how you’re framing that. And to me it also says that in order for you to move forward, you first have to deal with this legacy debt. You can’t really modernize yourself if you are running off an old mainframe or if you don’t have the right code base and those kinds of things.
[00:04:17] What suggestions do you have for healthcare leaders to lighten their legacy load or to start down this path of modernization?
[00:04:23] Lisa Esch: Well, I think that’s a great question. I think it really starts with just a deep strategy. A deep plan to figure it out and to really do the analysis of what you have and take inventory of that. Then have the ability to prioritize what you do rather than just always reacting to what’s new or what crisis is in the world today – we all know what the last two years have been like.
[00:04:46] Now IT can take a step back, reset the strategy, make sure the strategy, if you have one, is still aligned. The last couple of years have also uncovered some of the challenges that legacy has provided, and now it’s a chance to really improve that. There’s some very simple things you can do with the strategy, with the transformation, with infrastructure that support the rapid transformation that can happen. The rapid digitization of healthcare experience.
[00:05:15] Colin Hung: I think that’s, we’ve kind of proven to ourselves over the last few years. We know that we can actually adapt early and we can adapt quickly. We’ve shown ourselves in healthcare that we don’t have to spend years testing technology. We can go quickly. And I think that’s, that’s one of the encouraging things that have come out of the last two years.
[00:05:34] Lisa Esch: Right. And choosing a partner that can help you evaluate and figure those things out and be out in front of that is really key. It’ll help you with the prioritization and actually the execution of that, because it’s one thing to have a plan, but it’s the execution that really allows you to be successful.
[00:05:54] Colin Hung: Lisa, you shared a ton of great information today. I really liked where the conversation is going. What’s one thing that you want to give to our audience, listening and watching this. What’s the one takeaway.
[00:06:08] Lisa Esch: There are a lot of bright, shiny objects out there right now and it’s really important to just take a step back and breathe. If you’ve got a solid strategy and framework to make decisions with, you can pick the right things to do that really will help you accelerate versus end up with a hodgepodge of things that “I think I need this”. “I think I need that”, or “that’s cool”.
[00:06:30] Or from a standpoint of leadership, you’ve got a lot of highly educated people in healthcare that believe they know the right thing to do, and they see something. So there’s a lot of pressures in the organization to also do things that don’t necessarily align with the longer-term strategy. So having that strategy, having that framework to make decisions, having a partner that can help you with that, I think is really key to being smart about it – getting more out of your investments, but it’s rapidly changing. Don’t be distracted.
[00:07:01] Colin Hung: I think this is probably the place for it…Imagine if we had all adapted the latest, shiny object. Imagine how much legacy we would have now.
[00:07:09] Lisa Esch: We would have a lot of legacy.
[00:07:12] Colin Hung: Where can people go to find out more information about NTT? Yeah.
[00:07:18] Lisa Esch: NTTDATAservices.com We’ve got great resources there for you. Reach out to me directly. I’m on Twitter. I’m on LinkedIn. Feel free to do that.
