It’s easy to assume that healthcare technology is quickly evolving on all fronts. Media outlets constantly promote ‘breaking news’ on novel medical technology like robots that can perform intricate surgeries or a new pharmaceutical that can potentially cure a life-threatening disease. While these advancements are constantly being made, their implementation is a whole different (and much slower) story. 

 

Implementation Challenges

 

Hospitals are intricate, complex, and often fragile systems that have the challenging task of protecting, nurturing, and saving an important asset: human lives. Stakes are very high, and regulations are even higher.   

 

A few of the key challenges to implementing new technology in hospitals include: 

 

1. Cost:  The healthcare system is financially challenged to say the least. Costs are rising, patients have gotten sicker, and resource gaps are only growing. Therefore, functional administrators are fighting each other for the limited budget dollars available to manage their respective organizations, which leaves little room for new ideas and technologies that often overlap various silos. Implementing new technology can be expensive, particularly in a hospital setting where there is already a high demand for resources. The cost of new equipment, training, and infrastructure upgrades can be difficult to justify. Cross functional value analysis committees are sometimes formed to help make decisions to implement new disruptive solutions, but their scope and time commitment is often limited. This leads to a large group of stakeholders who may sometimes lack the time, patience, or perspective to help appropriately accelerate the most critical initiatives to the top of their list.
2. Resistance to change: Healthcare workers can be resistant to change, especially when it comes to disruptive technology. This is particularly true when staff are already dealing with complex and stressful environments and do not necessarily have the time and support to learn and implement new systems and processes. In our Culture Lag blog post, we describe how there’s a sociocultural layer associated with this resistance due to the strain that new technology can put on clinicians who are tasked with implementing it into existing workflows. In an ideal world, new technologies have an internal hospital champion that helps shepherd new vendors through the process while gaining support from various internal stakeholders, thus improving and accelerating technology implementation.   
3. Integration with existing systems: No new technology can be introduced without first understanding how it integrates with legacy solutions, because integration into existing systems and processes is key for effective implementation. Hospitals may have outdated legacy systems that differ across departments, which even further complicates technology updates. Integration must be well planned with the help of the appropriate system experts. Unfortunately, it’s not just clinicians that are short-staffed. The issue is even worse for hospital clinical engineering, IT, and informatics personnel. Certain technology integrations warrant a dedicated new hire just to manage the project. These projects can require significant effort, and there are many assessments to ensure all risks are mitigated before any project can begin. 
4. Data and Privacy: Many newer technologies are heavily leveraging patient and user data to feed their product solution. However, anyone accessing Protected Health Information (PHI) and Personally Identifiable Information (PII) may trigger many alerts within hospital administration. Implementing new technology can involve technical challenges, such as compatibility issues, data security and privacy concerns, and the need for specialized training. These challenges can be particularly acute in a hospital setting, where critical systems must remain operational 24/7.
5. Integration to existing workflows: Hospital employees are skilled workers who operate within tightly-regulated guidelines and training. Standard operating procedures (SOPs), protocols, and other continuous training are required for pretty much everyone in the hospital. As new technology is introduced, every policy, procedure, and workflow that it impacts must be documented, updated, reviewed, and re-trained. And these are just the steps AFTER the technology has been approved. 
6. Clinical Risk: Hospitals have a very low tolerance for risk. That translates to a desire for near perfect product performance. This is not a realistic expectation, but is the current reality and a barrier to technology adoption. The stakes are high for caregivers, which sets a very high bar for new medical technology, differentiating the space from other consumer technologies. Most medical technologies require clinical evidence before even being considered. This makes sense in most cases, though some disruptive technology solutions will not have this evidence, and must rely on clinical champions to advocate for pilot testing their products. The stakes are high, but the potential benefits could be substantially greater, and therefore worth it. 

 

The Red Tape Exists for a Reason

 

As stated earlier, hospitals are highly complex systems with many stakeholders and high stakes. From a macro level, new technology can be difficult to integrate into hospitals in general due to the complexity of these organizations that encompass numerous voices and competing priorities. Additionally, hospitals are often risk-averse organizations that are hesitant to invest in new technology unless it has been thoroughly tested and proven to be effective. This can make it difficult for new technology to gain a foothold in the hospital environment.

Furthermore, hospitals are large, somewhat ‘bureaucratic’ organizations with many different departments, regulations, and stakeholders, which can make it difficult to implement changes quickly and efficiently. Hospitals are focused on providing high-quality care to patients, and any changes to existing processes and procedures can be perceived as a threat to that quality. Finally, healthcare is heavily regulated, and disruptive technologies may introduce different processes and procedures that may require regulatory approval, which can be a slow and time-consuming process. 

Though it may seem painful and even extreme at times, all of the medical stakeholders, procedures and oversight exist for good reason. It’s important for technologists to learn the process, understand the risks and concerns that are covered, and communicate effectively with decision makers to address their concerns.

It Starts with Clinicians

 

Overall, the implementation of potentially life-saving technologies into rigid hospital structures requires a multi-faceted approach due to the many regulatory and procedural layers that make up these organizations. Expecting to quickly overhaul the existing healthcare system defined by rules, regulations, and stakeholders is not realistic. So how can we remove some of the friction and even accelerate adoption of new medical technologies?? Start with the people who use the technology every single day: the nurses, doctors, and other clinicians. 

No technology should be introduced without user input. Especially in healthcare. Collaborating with clinical users not only accelerates product learning and validation, but can shed a layer of resistance when it comes time to implement in hospitals. Engaging clinicians, getting their feedback, providing justification for adoption, and preparing them to advocate for technology integration can only improve the chances of adoption of novel life-saving products.

Conclusion

 

CalmWave understands the broader challenges facing healthcare, including the barriers in adopting disruptive technologies. Our technology impacts a wide range of stakeholders, including clinicians, hospital executives, and patients. By observing, listening, and learning from them throughout our design process, we believe we will successfully overcome the challenges that many others have struggled with.     

Disruptive technologies, by definition, are bound to cause discomfort. Especially because we are AI-based, it’s important to ensure clinicians understand the hows and whys of our algorithms and solutions. CalmWave is working to alleviate the discomfort by providing explainability at all levels.  Our artificial intelligence-based platform is taking on big issues that have plagued healthcare: alarm fatigue, cognitive overload, and burnout. Changes will need to be made that might cause skepticism or even irritation with some of our target users. It’s our hope that our early customers become those early adopters and champions who help us change the face of healthcare for the masses. Schedule a demo today at calmwave.ai if you want to see how we’re doing things differently, and/or want to partner with us.