Digital transformation of health services: a value stream-oriented approach

Health organisations have adopted technologies since the 1960s, but only after the Industry 4.0 were such technologies systematized and organised under the H4.0 acronym. The pace at which digital information and communication applications have been developed in recent years challenge healthcare managers to choose assertively those with the largest potential impacts on their operations. In this paper, we propose using value stream mapping, a technique from the lean healthcare (LH) toolbox, to guide the choice of H4.0 digital applications that are more likely to support the improvement of value flows in healthcare organisations. We propose a three-step method, starting with mapping current and future value streams of the process under analysis, gathering data from team members on the indicated kaizen bursts and H4.0 digital applications, and finally assessing and ranking H4.0 digital applications that best support improvements and comply with attributes that characterise successful technological innovations. Our propositions are illustrated through a case study conducted in the sterilisation unit of a large public university hospital. Our findings indicate that three H4.0 digital applications should be prioritised to support the improvement of the value stream under analysis. Our method combines the simplicity of LH with more sophisticated solutions brought by H4.0.