An introduction to digital maturity

The ‘digital agenda’ raises a hard problem in healthcare, to balance impact and profit against risks, like cybersecurity, regulatory lag and patient safety. Recent books such as The Digital Doctor (Wachter, 2015), The Patient Will See You Now (Topol, 2015) and First Do Less Harm (Koppel and Gordon, 2012) illustrate the gaps between hope and reality. We need digital maturity. Manufacturers need to think better than their competitors; healthcare needs to think better to provide quality care. It is useful to think of digital maturity to be about people and how they understand digital.

For many (Wachter, 2016) ‘digital maturity’ means digital infrastructure, not competency. Specifically, it means readiness (how much do you deploy digital); capability (how much do you use digital) and infrastructure (how much infrastructure supports this). This definition focuses on tech, not on understanding. On the contrary, once you have digital maturity as understood in this white paper (there is a literature on maturity, see, e.g. the Wikipedia article, 'Capability Maturity Model’, 2018), you can more effectively develop, evaluate, buy and use digital. It does not work the other way around.

The scale of healthcare, its levels of ad hoc paper-based information and digital legacy begging for modernization, including with apps and portals, raise questions of digital maturity. How do we promote digital maturity in healthcare, which has a traditionally non-digital culture?

In contrast, the rate of change in digital is staggering. Apple’s iPhone appeared only in 2007 and introduced us to smartphones, medical apps, personal digital health and more. Now these technologies and the business cultures seem natural and ubiquitous.

High-profile innovators like Amazon, Facebook, eBay and so on inspire trying to tackle healthcare the same way. However, conventional businesses and healthcare have different approaches to safety and error. If an e-commerce operator makes a mistake, they can refund you. In contrast, if a hospital makes a mistake, this may be a disaster, regardless of any ‘refund’.

Nobody has thought of a workable way to digitalize health as you can digitize commodities. Health is not fungible (fungible means that things, such as money, shoes or software, are freely interchangeable.). You cannot refund a bug, bad action or decision – you can’t return your body to Amazon if the device does not work as hoped.

Although different business models can thrive after digital transformation, we need to be aware that in healthcare the standards and the regulatory frameworks are different – for good reason. This means that the ‘low-hanging fruit’ of much digital innovation may not translate successfully into healthcare

This is an excerpt from the white paper "Digital maturity in an age of digital excitement'. To download our other medical device white papers, please visit the Insight page on the Compliance Navigator website.