Understanding healthcare practitioners’ needs in the area of smart digital solutions for medical recording A Case Study in Swedish private healthcare

Abstract

Improvement science in healthcare has gained traction in recent years, driven by the extensive challenges of resource scarcity and need for efficiency. While previous research has underscored the importance of patient-centeredness, there remains a gap in considering the perspective of the healthcare practitioners’ role in creating patient centeredness care. The healthcare practitioners are in this thesis considered internal customers in healthcare organisations while patients are external customers. Research has previously focused on the service quality for patients, thus external service quality. Yet, ensuring internal service quality is vital to ensure patient-centred care as it enables healthcare practitioners’ capabilities to provide qualitative service to patients. At the same time, healthcare is undergoing significant changes with digitalisation and upcoming initiatives with automation that potentially also could influence service quality. The purpose of this thesis was to identify internal customers’ needs and requirements in the development of an automated medical recording service. Furthermore, this study investigated potential barriers and enablers for implementing change and examined how modularity can be a means of providing high service quality during implementation of new digital services. The purpose was addressed through a case study with an IT company that sells digital solutions to private healthcare clinics. To thoroughly understand the internal customers’ (in this case the healthcare practitioners’) needs, the Kano model was applied. To generate quality attributes, interviews were held with medical practitioners and were then used as a basis for questions in a Kano survey. The Kano survey revealed several critical attributes, where correct interpretation of words and grammar, speed of automation, and integration of referral systems were highlighted as important for satisfaction. Further, barriers and enablers to change among medical practitioners were uncovered. Doctors showed to be most ready for digitalisation and automation whereas medical scribes showed highest resistance. Quality and ethical aspects of automation, such as accuracy and accountability, were identified as crucial considerations. A modular approach, tailored to the varying needs and readiness levels of different professional roles and types of healthcare clinics was proposed. This approach involves assessing readiness, creating a sense of urgency, involving stakeholders in the change process, and gradually implementing modular offerings to address specific needs and barriers. Overall, the findings underscore the importance of understanding internal customer perspectives, addressing potential barriers to change, and adopting a tailored, modular approach to implementing automated medical recording services in healthcare organisations.