At CODE24, we work daily on the ‘hard’ side of healthcare IT: open data standards, robust architectures, and systems that integrate seamlessly with one another. But anyone who knows us well also knows that we always keep an eye on the human side of technology. You can build the most advanced solution imaginable, but if it fails to resonate with healthcare professionals in practice, it ultimately achieves very little.
Of course, it is one thing to say this, and quite another to support it with data. This brings us to the graduation thesis of our colleague Suzanne van der Lee (Product Manager at Lab24). Before joining the CODE24 team, Suzanne completed her Master’s in Medical Informatics at the University of Amsterdam. Her thesis, entitled “Redesigning to be usable: a pre and post redesign evaluation study on the effectiveness, socio-technical integration and usefulness of a DBC registration tool”, addresses precisely this question surrounding the effectiveness of new healthcare technologies. Suzanne investigated why a redesigned feedback tool for DBC registration became a major success in Hospital A, while in Hospital B it was barely used at all. What makes the implementation of healthcare technology successful?
The Multi-Million-Euro Question Behind DTC Registration
DTC registration (Diagnosis Treatment Combination) plays a crucial role within the healthcare system. Incorrect registrations lead to enormous administrative burdens and financial inaccuracies. In 2016 alone, insurers reclaimed no less than €3 billion nationwide following audits and checks. That is money we would far rather see invested directly into patient care.
Software suppliers developed intelligent tools to detect and correct these errors. Suzanne examined what happened when one such tool was completely redesigned. Would the tool actually be used more frequently? And would a sleek new design result in better healthcare administration?
DIVING into the data
Suzanne analysed the data and discovered something striking. She divided hospitals into groups based on their level of usage. The ‘power users’ resolved an average of 20% of their incorrect registrations through the tool and even logged in during weekends. The ‘minimal users’ lagged far behind.
You might assume the technology itself was the issue. However, usability tests – during which users verbalised their thoughts while operating the tool – revealed that the technology was rarely the bottleneck. Although the redesigned interface introduced a temporary learning curve, the so-called ‘SUS score’ (a standard measure of usability) remained comfortably above average.
The real culprit? It was not hidden in the code, but in the context.
People, Tasks, Technology and Structure
The key conclusion of Suzanne’s research was that the success of a digital tool is determined by its socio-technical integration. Four components – and the relationships between them – play a central role:
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The actors (people): who is expected to use the system, and do they understand why it matters?
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The tasks: does the tool fit naturally into the daily workflow, or does it create another obstacle?
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The structure (organisation): is the organisation centrally managed, and is there a clear process owner?
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The technology: the solution itself, in this case the DBC tool.
Suzanne discovered that hospitals where tasks were centralised and where there was a clear organisational structure surrounding the tool were significantly more effective. The technology itself was merely the facilitator; the implementation process and integration into everyday workflows were the decisive factors behind success.
What Does This Mean for the Future of Healthcare?
At CODE24, we strongly believe in the power of smart digitalisation and flexible healthcare IT. But Suzanne’s research serves as an important reminder that we are never simply ‘delivering software’. We are delivering a solution to a human problem.
Whenever we digitalise healthcare processes, we must continually ask ourselves: does this truly fit within the structure of the healthcare organisation? Are we supporting healthcare professionals in their work, or are we making things more complex?
Curious about how we approach the implementation of data-driven healthcare within your organisation? Our colleagues would be delighted to help you think about how technology can successfully ‘land’ within day-to-day operations. Explore our wide range of solutions or get in touch with us.