Process

 

Leading the clinical requirements gathering process from a ‘model of care’ focus instead of allowing technology to drive the model

What is a ‘model of care’?

A model of care is a framework that outlines the daily operations of a health service and how it delivers clinical care. It may be informal or undefined, and the organisation may not refer to it as a model of care. A model of care is underpinned by formalised policies and procedures that incorporate best practice for care delivery, as well as business practices that support the optimal care and services for patients.

A model of care-approach

Taking a model of care approach prioritises a system or technology that is designed to support the existing processes of a clinical service instead of allowing the technology to drive the model. Historically, the design of digital health systems has been driven by available technology and how possible it was to customise to local workflows and processes. In recent years there has been a significant digital transformation in healthcare with advancements in technology and an increase in the number of vendors in the market. This has brought about a paradigm shift in negotiating power that has given healthcare services greater power to request functional requirements when buying a new system or technology.

Why is gathering clinical requirements important?

When purchasing a new digital health system, technology or service, it is essential to understand the model of care and how it will be used. A comprehensive list of clinical requirements will operate as the definition of the desired outcome. It will also form part of the formal agreement with the preferred vendor.

Digital health system procurement can be more challenging than procurement in other industries. Digital health systems need to support clinical practice and workflows because they are linked to patient outcomes in potentially life-threatening situations.

Benefits of the model of care-approach

If systems do not meet the requirements of clinicians, then acceptance, and subsequent use of the system or technology will not be achieved. If a system gets in the way of optimal patient care, there is a risk clinicians will not use the system.

Benefits of a model of care-approach include:

• improved patient safety outcomes as a system that matches the clinical requirements will support clinical workflows, improve access to important information and capture relevant data and documentation required to support clinical decision making
• reduction in cost of the project overall by identifying exactly what is needed up front, providing vendors a clear understanding of what they need to deliver against. This is a much more cost-effective way to deliver a new system or technology, as fixing issues detected during or after implementation can result in additional costs
• decrease risk of project failure as the requirements inform implementation and change management plans. Aligning high priorities of clinicians will greatly increase the chance of success.

Throughout the procurement process it is important to prioritise the needs of users to ensure the system or technology is fit-for-purpose for clinical care and technology alone is not driving decision-making.

Planning for clinical requirements gathering 

In the pursuit of gathering clinical requirements, there is a risk of too little or too much engagement. Too little may result in failing to collect a comprehensive list of requirements; too much, on the other hand, risks over-engineering the requirements and impacting project timeframes.

To avoid this, have a plan that includes:

• the total timeframe allocated for the procurement process
• a defined governance process and stakeholders identified for approval and engagement
• defined methods of engagement
• a detailed schedule of the process, including the stages of gathering, prioritisation and validation of requirements.

To manage the expectations of those involved, it is critical to clearly communicate this plan to all stakeholders at the start of the process. This will allow opportunity for feedback to be incorporated and support buy-in of the process and acceptance of the outcome.