Digital orientation: Conceptualization and operationalization of a new strategic orientation

Kindermann, Bastian; Beutel, Sebastian; Lomana, Gonzalo Garcia de; Strese, Steffen; Bendig, David; Brettel, Malte

doi:10.1016/j.emj.2020.10.009

Cited by 161 publications

(174 citation statements)

References 63 publications

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“…We also recognize that the underlying tone in this study is that the growth and futuristic orientation is more important than the customer and analytic orientation for health systems, following prior research [ 4 , 27 ]. However, in the current US health care industry, we acknowledge that customer orientation and analytics-driven intelligence also play significant roles in improving quality and efficiency while reducing care delivery costs.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Digital orientation as a strategic direction exhibits superior performance by using and leveraging technology in different ways and through different means while maintaining a view of current and futuristic options [ 4 ]. A specific digital orientation can be examined from perspectives such as technology scope and capabilities [ 4 ]. Different digital orientations shape the way organizations create and adapt behaviors and resources [ 5 , 6 ], similar to market orientation (eg, [ 7 ]) and entrepreneurial orientation (eg, [ 8 ]), which have been extensively studied as sources of competitive advantage [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Digital Orientation of Health Systems in the Post–COVID-19 “New Normal” in the United States: Cross-sectional Survey

Khuntia¹,

Ning²,

Stacey³

2021

J Med Internet Res

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Background Almost all health systems have developed some form of customer-facing digital technologies and have worked to align these systems to their existing electronic health records to accommodate the surge in remote and virtual care deliveries during the COVID-19 pandemic. Others have developed analytics-driven decision-making capabilities. However, it is not clear how health systems in the United States are embracing digital technologies and there is a gap in health systems’ abilities to integrate workflows with expanding technologies to spur innovation and futuristic growth. There is a lack of reliable and reported estimates of the current and futuristic digital orientations of health systems. Periodic assessments will provide imperatives to policy formulation and align efforts to yield the transformative power of emerging digital technologies. Objective The aim of this study was to explore and examine differences in US health systems with respect to digital orientations in the post–COVID-19 “new normal” in 2021. Differences were assessed in four dimensions: (1) analytics-oriented digital technologies (AODT), (2) customer-oriented digital technologies (CODT), (3) growth and innovation–oriented digital technologies (GODT), and (4) futuristic and experimental digital technologies (FEDT). The former two dimensions are foundational to health systems’ digital orientation, whereas the latter two will prepare for future disruptions. Methods We surveyed a robust group of health system chief executive officers (CEOs) across the United States from February to March 2021. Among the 625 CEOs, 135 (22%) responded to our survey. We considered the above four broad digital technology orientations, which were ratified with expert consensus. Secondary data were collected from the Agency for Healthcare Research and Quality Hospital Compendium, leading to a matched usable dataset of 124 health systems for analysis. We examined the relationship of adopting the four digital orientations to specific hospital characteristics and earlier reported factors as barriers or facilitators to technology adoption. Results Health systems showed a lower level of CODT (mean 4.70) or GODT (mean 4.54) orientations compared with AODT (mean 5.03), and showed the lowest level of FEDT orientation (mean 4.31). The ordered logistic estimation results provided nuanced insights. Medium-sized (P<.001) health systems, major teaching health systems (P<.001), and systems with high-burden hospitals (P<.001) appear to be doing worse with respect to AODT orientations, raising some concerns. Health systems of medium (P<.001) and large (P=.02) sizes, major teaching health systems (P=.07), those with a high revenue (P=.05), and systems with high-burden hospitals (P<.001) have less CODT orientation. Health systems in the midwest (P=.05) and southern (P=.04) states are more likely to adopt GODT, whereas high-revenue (P=.004) and investor-ownership (P=.01) health systems are deterred from GODT. Health systems of a medium size, and those that are in the midwest (P<.001), south (P<.001), and west (P=.01) are more adept to FEDT, whereas medium (P<.001) and high-revenue (P<.001) health systems, and those with a high discharge rate (P=.04) or high burden (P=.003, P=.005) have subdued FEDT orientations. Conclusions Almost all health systems have some current foundational digital technological orientations to glean intelligence or service delivery to customers, with some notable exceptions. Comparatively, fewer health systems have growth or futuristic digital orientations. The transformative power of digital technologies can only be leveraged by adopting futuristic digital technologies. Thus, the disparities across these orientations suggest that a holistic, consistent, and well-articulated direction across the United States remains elusive. Accordingly, we suggest that a policy strategy and financial incentives are necessary to spur a well-visioned and articulated digital orientation for all health systems across the United States. In the absence of such a policy to collectively leverage digital transformations, differences in care across the country will continue to be a concern.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Digital Orientation of Health Systems in the Post–COVID-19 “New Normal” in the United States: Cross-sectional Survey

Khuntia¹,

Ning²,

Stacey³

2021

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…Digital orientation as a strategic direction exhibits superior performance by using and leveraging technology in different ways and through different means while maintaining a view of current and futuristic options [4]. A specific digital orientation can be examined from perspectives such as technology scope and capabilities [4]. Different digital orientations shape the way organizations create and adapt behaviors and resources [5,6], similar to market orientation (eg, [7]) and entrepreneurial orientation (eg, [8]), which have been extensively studied as sources of competitive advantage [9].…”

Section: Literature Review: Digital Orientationsmentioning

confidence: 99%

Digital Orientation of Health Systems in the Post–COVID-19 “New Normal” in the United States: Cross-sectional Survey (Preprint)

Khuntia¹,

Ning²,

Stacey³

2021

Preprint

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BACKGROUND How are health systems in the United States embracing digital technologies? Many health systems are overwhelmed. Others have tried to stay current with the dramatic changes of the past year by leapfrogging selected digital technologies during the COVID-19 pandemic. It appears that almost all health systems have developed some form of customer-facing digital technologies and worked to align those to their existing electronic health records to accommodate the surge in remote and virtual care deliveries. Still, others have developed analytics-driven decision-making capabilities. However, even with all these developments, there seems to yet a gap in health systems’ ability to integrate workflows with expanding technologies to spur innovation and futuristic growth. There is a lack of a reliable and reported estimate of the current digital orientation of health systems. Periodic assessments will provide imperatives to policy formulation and align efforts to yield the transformative power of emerging digital technologies. OBJECTIVE To explore and assess US health systems’ differences in digital orientations in the post-COVID-19 “new normal” in 2021. Differences were assessed in four dimensions: 1) Analytics and Intelligence Oriented Digital Technologies (AODT) 2) Customer Oriented Digital Technologies (CODT) 3) Growth and Innovation Oriented Digital Technologies (GODT), and 4) Futuristic and Experimental Digital Technologies (FEDT) The earlier two are foundational to health systems’ digital orientation, while the latter two will prepare for future disruptions. METHODS We surveyed a robust group of health system CEOs (total 625) across the United States during Feb-Mar 2021. Twenty-two percent of the CEOs (135) responded to our survey. We considered the above four broad digital technology orientations and ratified with experts’ consensus. Secondary data was collected from AHRQ Hospital Compendium, leading to the matched usable dataset for 124 health systems for analysis. We examined the relationship of adopting the four digital orientations to specific hospital characteristics and factors that were earlier reported widely as barriers or facilitators to technology adoption. RESULTS We found that health systems have a lower level of customer (CODT mean= 4.70) or growth (GODT mean= 4.54) orientations, compared to analytics and intelligence digital orientation (AODT mean= 5.03); while health systems have the least futuristic digital orientation (FEDT mean= 4.31). The ordered logistic estimation results provided nuanced insights. Medium (P<.001) and large-sized(P<.05), major teaching (P<.001), and systems with a high burden hospital (P<.001) are doing worse in AODT orientations, raising some concerns. Health systems with medium (P<.001) and large sizes (P<.05), major teaching (P<.1), high revenue (P<.05), and with a high burden hospital (P<.001) have less customer-oriented digital technology or CODT. Interestingly, we found that health systems in Midwest (P<.05) and South (P<.05) are more likely to adopt growth-orientated technologies, while high revenue (P<.01) and investor ownership (P<.05) deters from GODT. Health systems in with the medium size and are in Midwest (P<.001), South (P<.001), and West (P<.05) are more adept to FEDT; while medium (P<.001) and high revenue (P<.001), and those with a high discharge (P<.05) or high burden hospital (P<.01) have subdued FEDT orientations. CONCLUSIONS Not surprisingly, almost all health systems have some current foundational digital technological orientations to glean intelligence or service delivery to customers, with some notable exceptions of lower adoptions in some sets of health systems. Comparatively, fewer groups of health systems have growth or futuristic digital orientations. The transformative power of digital technologies can be leveraged ONLY by adopting futuristic digital technologies. Thus, the disparities across these orientations suggest that a holistic, consistent, and well-articulated digital orientation direction across the United States remains elusive. This lack of consistency exacerbates different outcomes across different health systems and regions in the United States. Accordingly, the authors suggest that a policy strategy and financial incentives are necessary to spur a well-visioned and articulated digital orientation for all health systems across the United States. In the absence of such a policy to collectively leverage digital transformations, differences in care across the country will continue to be a concern.

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“…For example, a company that invests in the digital skills of its workforce may end up adapting its business model to capture more value from its workers' offerings. Further research is also needed on the correlation between investments in digital skills and other outcomes for the company, such as innovation, new products or services, and customer satisfaction, regardless of employee perceptions [48]. Finally, the concepts assigned to each parameter and business field should be considered revisable over time as the transformation itself evolves.…”

Section: Limitation and Avenues For Future Researchmentioning

confidence: 99%

Digital Inability and Social Sustainability in the Face of the Fourth Industrial Revolution: A Proposal of New Non-Financial Indicators

Martín

Zurdo

2021

Sustainability

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In the knowledge economy, financial indicators are not sufficient to predict the evolution of business competitiveness and anticipate risks. This paper proposes new non-financial indicators based on the analysis of eighteen variables representative of the interest of the different stakeholders, which correlate the organization’s commitment to socially sustainable digital transformation and the enhancement of business capabilities. This study, based on a specific adaptation of the IMPACT methodology and carried out in forty countries, obtains as main findings that there are significant differences in the perception of the business impact generated by the improvement of the digital capabilities of the workforce according to variables, such as job level, area of work, cultural area of the interviewee, type of company, or the number of years that digital training programs have been implemented among the workforce, while factors, such as gender or generation of the interviewee, company size, or productive sector, are not determinant. The proposed analysis methodology provides useful indicators for corporate governance bodies to analyze and improve human performance and labor engagement in the face of digitalization, applicable to any type of organization, sector, or country, facilitating the deployment of more economically efficient and socially sustainable transformation programs.

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Digital orientation: Conceptualization and operationalization of a new strategic orientation

Cited by 161 publications

References 63 publications

Digital Orientation of Health Systems in the Post–COVID-19 “New Normal” in the United States: Cross-sectional Survey

Digital Orientation of Health Systems in the Post–COVID-19 “New Normal” in the United States: Cross-sectional Survey

Digital Orientation of Health Systems in the Post–COVID-19 “New Normal” in the United States: Cross-sectional Survey (Preprint)

Digital Inability and Social Sustainability in the Face of the Fourth Industrial Revolution: A Proposal of New Non-Financial Indicators

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