Resilient by Design: Integrating Risk Management into Enterprise Healthcare Systems for the Digital Age

Abstract

Although resilient performance (RP) in health services can be both enhanced and hindered by the use of digital technologies (DTs), little is known on how this influence occurs through design. This study introduces a framework for designing resilient health services supported by DTs, involving four steps: (i) define the motivation for the framework application, select the target system, and form a project team; (ii) modeling of the target system; (iii) identify problems and countermeasures, emphasizing the role of DTs supportive of RP; and (iv) implement countermeasures. The framework was tested in the blood transfusion process of a large tertiary hospital. Data collection for this test included participant and non-participant observations, interviews, and documentary analysis. Results shed light on the framework's utility and ease of use, also giving rise to propositions that guide the framework application. These propositions are related to using business process management notation to bridge the perspectives of DTs designers and human factor experts; supporting dynamic prioritization of orders; standardizing interactions between management information systems; using DTs to amplify rather than replace human skills; using DTs to buy time for deploying responses to variabilities; accounting for the perspectives of diverse stakeholders; and learning from applying the framework. Requirements of DTs supportive of RP were also derived from the propositions, offering guidance to designers.