School of Public Health, University of Queensland, Queensland, Australia.
Metro South and Integrated Nephrology and Transplant Services, Princess Alexandra Hospital, Queensland, Australia.
Appl Clin Inform. 2021 Oct;12(5):1135-1143. doi: 10.1055/s-0041-1740190. Epub 2021 Dec 1.
The COVID-19 pandemic has forced rapid digital transformation of many health systems. These innovations are now entering the literature, but there is little focus on the resulting disruption.
We describe the implementation of digital innovations during the COVID-19 response of Australia's largest health service, Metro North (in Brisbane, Queensland), the challenges of the subsequent digital disruption, how these were managed, and lessons learned.
Prior to the COVID-19 pandemic, the Australian state of Queensland created the Queensland Digital Clinical Charter, which provides guidance for the development of digital health programs. The guidelines utilize three horizons: digitizing workflows, leveraging digital data to transform clinical care, and reimagining new and innovative models of care. The technical response to COVID-19 in Metro North is described across these horizons. The rapid digital response caused significant disruption to health care delivery; management of the disruption and the outcomes are detailed. This is a participatory action research project, with members of the research team assisting with leading the implementation project informing the case report content.
Several digital innovations were introduced across Metro North during the COVID-19 response. This resulted in significant disruption creating digital hypervigilance, digital deceleration, data discordance, and postdigital "depression." Successful management of the digital disruption minimized the negative effects of rapid digital transformation, and contributed to the effective management of the pandemic in Queensland.
The rapid digital transformation in Metro North during COVID-19 was successful in several aspects; however, ongoing challenges remain. These include the need to improve data sharing and increase interoperability. Importantly, the innovations need to be evaluated to ensure that Metro North can capitalize on these changes and incorporate them into long-term routine practice. Moving forward, it will be essential to manage not only the pandemic, but increasingly, the resultant digital disruption.
COVID-19 大流行迫使许多卫生系统迅速实现数字化转型。这些创新现在正在进入文献，但几乎没有关注由此产生的中断。
我们描述了澳大利亚最大的卫生服务机构 Metro North（位于昆士兰州布里斯班）在 COVID-19 应对期间实施数字创新的情况、随后数字中断的挑战、如何管理这些挑战以及从中吸取的经验教训。
在 COVID-19 大流行之前，澳大利亚昆士兰州制定了《昆士兰数字临床宪章》，为数字卫生项目的发展提供了指导。该指南利用三个层面：数字化工作流程、利用数字数据改变临床护理、以及重新构想新的和创新的护理模式。描述了 Metro North 在这些层面上对 COVID-19 的技术应对。在 Metro North，对 COVID-19 的快速数字化响应对医疗保健服务的提供造成了重大干扰；对干扰的管理及其结果进行了详细描述。这是一个参与式行动研究项目，研究团队的成员协助领导实施项目，为案例报告的内容提供信息。
在 COVID-19 应对期间，Metro North 推出了多项数字创新。这导致了重大的干扰，造成了数字高度警惕、数字减速、数据不一致和后数字“抑郁”。成功管理数字中断最大限度地减少了快速数字化转型的负面影响，并有助于昆士兰州有效管理大流行。
Metro North 在 COVID-19 期间的快速数字化转型在几个方面取得了成功；然而，仍存在持续的挑战。这些包括需要改善数据共享和提高互操作性。重要的是，需要对这些创新进行评估，以确保 Metro North 能够利用这些变化，并将其纳入长期常规实践。展望未来，管理不仅是大流行，而且是越来越多的由此产生的数字中断，将是至关重要的。
