| | JULY 20229Scenario 1 ­Digital transformation as a Clinician AffairEarly clinician engagement and involvement in the design and strategic direction of hospital digital programmes can create a sense of ownership and belonginess amongst clinicians, which can spread across all levels of the organisation. · Clinical leaders and champions of digital programmes often play the role of middle-level managers and `bridges' between the executive team and the front-line adopters of digital innovations, ensuring that communication about the vision and benefits of digital transformation programmes is consistent and unified. · The clinical leader and digital champion involvement in the technical design and implementation of new technologies as well as in the training of peers within the organisation, can be instrumental in catalysing technological adoption across all organisational levels and ensuring that data is managed in an organised and safe manner.· Clinicians are best placed to drive patient engagement in an attempt to co-design aspects of the new technologies such as patient portals, ensuring that clinician-patient communication is optimised and data flows are safe and meaningful through the use of such digital tools. The digitisation of health records can be considered as a Clinician Affair in this scenario as it is shaped and driven by clinicians who are championing digital innovations, with the intention of changing how clinicians work for the better. Through the broader adoption of such technologies by clinicians, improvements in process and cost efficiencies, patient safety, as well as end user experience can more easily materialise. Clinicians are more likely to gain confidence in the organisational innovation capabilities and continue to innovate and generate research from data analytics in all service areas.Scenario 2 ­The Clinician as Bystander in Digital TransformationThe opposite scenario of the clinician as a bystander throughout the digital transformation process, can lead to different implementation outcomes, based on the organisational and clinician attitude to innovation.The combination of an entrepreneurial organisational culture and a critical mass of clinician-innovators and early adopters, can lead to the successful implementation of digital technologies without much effort from clinicians. The opposite is true for organisations without innovation and commercial capabilities and whose clinicians are late adopters of innovations. If clinicians are also disengaged throughout the digital transformation process, then the risks are multiple and include: · Delays in the delivery of the digital programme;· Implementation of digital technologies which don't serve the purpose of the service they are intended for;· Increasing costs from last minute systems additions and reconfigurations;· The failure of patient pathways to serve their purpose, potentially introducing patient harm risk. If clinicians are not engaged early in the digital transformation process in this scenario, they are likely to lose trust in the organisation leadership capabilities and also lose their opportunity for their practice and their patients to benefit from digital technology. Late adopters and laggards are more likely to display disbelief in the digital programme benefits which is why early engagement is key for such clinicians. Clinician autonomy and enablement through targeted education and training in change management, digital strategy and implementation skills can go a long way in ensuring that organisations deliver a safe and effective collection of digital technologies. The role of external providers and delivery partners with experience in change management and the delivery of complex programmes could be invaluable in this scenario.If we are debating whether electronic health record digitisation is a Clinical Affair or a Clinical Bystander, the answer is rooted in the organisational culture and values. The safest route to success in digital transformation is undoubtedly, in our opinion, through clinician ownership and bottom-up methods, rather than having clinicians as passive observers in digital transformation. Early clinician engagement and involvement in the design and strategic direction of hospital digital programmes can create a sense of ownership and belonginess amongst clinicians, which can spread across all levels of the organisation
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