As the covid-19 pandemic spread across the US, one of the world’s worst-affected countries, hospitals faced an unprecedented dual challenge: coping with the surge in patients with a novel disease while continuing to care for the many non-covid patients whose needs could not be ignored. 

From ensuring prompt cancer diagnosis to regular management of chronic conditions like diabetes – itself a covid-19 risk factor – treating non-covid patients during the early heights of the pandemic required a far-reaching reimagination of technology and data, and the systems and mindsets needed to apply both to achieve optimal care. Out of the wreckage of the pandemic, there is evidence of long-term positive changes to US hospitals across all aspects of their services.

Chief information officers (CIOs) and chief technology officers (CTOs) played a critical role in guiding technology adoption and fitting short-term pivots into an alreadyexisting imperative to transition hospitals into the digital era. In the short term, data dashboards helped hospitals to manage scarce resources, from personnel to masks and intensive care unit space, while new partnerships with outside partners brought new levels of service agility, such as the production of 3D-printed facemasks. But leading CIOs believe that the covid-19 crisis has created an opportunity to deploy digital technology across the care spectrum in ways that could permanently re-shape how hospitals operate.

Opportunities

• The necessity of using digital technology to deliver care during covid-19 is akin to a pilot scheme. It has created the opportunity for hospitals to understand how best to utilise digital technology in the short, medium and long term.
• Covid-19 has disrupted not just healthcare delivery, but attitudes. Hospital executives anticipate that the changes made in response to covid-19 will lead to long-term changes to healthcare delivery. Attitudes have shifted, with digital technology now perceived as core to service delivery, rather than an add-on.
• Many hospitals had digital systems in place prior to covid-19, but these had not been widely utilised. Those hospitals able to scale up their systems, for example using cloud-based solutions, have seen rapid and large increases in use.
• Communication and understanding between hospital digital teams and the rest of the workforce is key to bring everyone along with the digital transformation.
• Innovative partnerships within and across organisations including hospitals, academic centres and public health entities have been implemented during covid-19. These include data-sharing partnerships that have facilitated decision-making and response planning. These reactive and short-term partnerships could provide a technical and attitudinal basis for long-term partnerships.
• To realise the opportunities that have arisen in the wake of covid-19, hospitals should seek to understand how, where and when digital technology has (and has not) worked during the pandemic. Capitalising on the shift in attitudes amongst stakeholders and using these experience-based insights could see these temporary changes translate to long-term service transformation to the benefit of all stakeholders.

Challenges

• Strategic direction is needed to ensure that scaling up existing systems or investing in new systems is guided by the organisation’s long-term vision and ensures sustainability.
• Scaling up digital systems requires an IT workforce with the knowledge to understand and define the needs of the various organisational stakeholders and patients.
• The workforce delivering care to patients needs training and support to use new systems that is not just technical in nature, but also recognises that delivering high quality digital care requires a different approach to delivering face-to-face care. Training creates a logistical challenge and requires investment of time and resources.
• The digital divide should be acknowledged – not all patients own a compatible device, have suitable internet or telephone connectivity, or have the digital skills to use the technology. Supporting patients through training and technical set-up has been helpful during covid-19, but new delivery models combining face-to-face and digital services need to ensure that they are inclusive.