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Digitally enabled collaborative work needs organisational capacity to succeed

This blog is part of a wider project on interoperability. The work for this project has been sponsored by TPP. The associated report, which was published in September 2022, was independently developed, researched and written by The King’s Fund. The sponsor was not involved in its development, research or creation and all views are the authors’ own.

I’m late, I’m late, for a very important date!

We all know how the pressure of work builds and builds and builds and no matter how fast we go we never quite seem, or barely seem, to be going fast enough and getting enough done. What we think we know, however, is that there is so much to do and so little time to do it that we really must go as fast as we possibly can.

Yet, like Lewis Carroll’s White Rabbit this can leave us confused, frenetic and unfocused and we can find that efforts to transform services and use revolutionary technology don’t have the anticipated impact. Like the White Rabbit we may find that ‘The hurrier I go, the behinder I get.’

When this kind of frenetic and fast-paced activity becomes the norm in a system it becomes confused, difficult to navigate and can feel like there are a million and one unfinished and poorly planned projects running at any given time.

Identifying the different nature of problems is vital in working out how we may best respond to them. And not all problems are the same. Some are technical problems that may be complicated, but can be solved with expertise. Here efficient and lean operational processes maximise the pace at which technical problems can be solved.

'Identifying the different nature of problems is vital in working out how we may best respond to them.'

On the other hand, some problems are ‘wicked’ problems, that is they are complex and adaptive challenges with unknown elements and unseen aspects to discover. This is often the case for digital transformation where people are implementing new or unfamiliar technologies in a changing environment with staff holding a range of attitudes and behaviours.

When trying to use technology to work collaboratively across organisations often the challenge isn’t the technology but developing the relationships and ways of working between the staff. It’s really hard to make the time and find the space to build the relationships and ways of working that will be most helpful in these circumstances, but doing so can have a real impact on the time pressures faced by staff and the experiences of patients. Our recent work focused on developing workshop structures that create space, reduce anxiety, ensure equal participation and enable problems to be more deeply understood. Doing this means that approaches to solving challenges can be thoroughly thought through by everyone involved and affected. It may seem counter-intuitive to spend time in conversation but time can be wasted by our behaviour; if we change our behaviour, we can increase our sense of time.

Technology doesn’t function in a vacuum, but also depends on those who use it for its success. The benefits of well-thought-through and well-crafted technology-enabled services that have considered a wide range of stakeholders and impacts are vast. Not only in terms of monetary and time savings, but perhaps even more importantly on the reduced levels of stress, anxiety and frustration for those involved.

'Working processes that are about connecting, learning and careful iterative step-taking create a multitude of better outcomes.'

Working processes that are about connecting, learning and careful iterative step-taking create a multitude of better outcomes. This careful way of making progress improves the potential for success and the impact of digital transformation. It leads to resilience, support, a place people learn and want to be, and improved outcomes for service users. With current pressures on health and care staff so high, it can be difficult to justify spending time in discussion but not doing so means transformational technologies may not realise their potential.


Interoperability is more than technology

Digital technologies can enable better collaboration between health and care partners, but what's needed to progress interoperability in an integrated care system? Our new report looks at the role of relationships and technology, and considers the wider enablers needed to truly join up services.