Achieving patient agility, i.e., the ability to sense patients’ needs and respond accordingly, requires more than just a technical change. It requires a true shift within hospitals from people and processes to technology. Therefore, here developed a framework based on cross-sectional survey data from 90 clinical hospital departments in the Netherlands that provides hospital decision- and policymakers with the required accelerators to deliver quality projects in clinical practice while still providing the flexibility needed to solve each unique challenge.

This process-based framework contains three major stages, i.e., (I) orchestrating IT capabilities, (II) leveraging patient agility, and (III) monitoring service and market value, which are tightly associated with the concepts and the IT-driven value path this study investigates. At each stage, essential drivers and enhancement activities will be discussed.

At the orchestration stage, the hospital department needs to develop technical, and management skills and IT practices to align IT applications with goals and strategic priorities. Leveraging IT resources is crucial to meet new business requirements, adapt to changing market conditions, and obtain business benefits ^[1][2][3][4]. Additionally, departments should develop the ability to master digital technologies, drive digital transformations, and develop innovative patient-centered services and products. Hospitals also need to develop knowledge processes alongside technical skills and competencies ^[5]. Knowledge processes are crucial operations with hospital departments that facilitate the transformation of clinical data into patient-related insights, thereby supporting clinicians within hospitals to make informed decisions concerning diagnosis and treatment ^[6][7][8]. Knowledge processes enhance other organizational capabilities based on the degree of knowledge reach and richness that the organization can achieve ^[9][10]. In sum, orchestrating knowledge processes and digital practices is crucial to driving the productivity of hospital departments.

Key driving activities at this stage include the diagnosis of the current interplay between formal, interpersonal, and cultural mechanisms in the department to identify possible barriers to the desired strategy and change. It is also essential to engage all stakeholders, i.e., medical providers and supporting staff, to rapidly embrace the digital transformation and various (innovative) IT improvement initiatives. Likewise, the digital skills and competencies needed for success must be clearly articulated. This has important implications for the hospital department managers and decision-makers, as the individuals and teams involved in clinical practice and improvement projects need the appropriate skills and training. Therefore, the deployment of digital skills and competencies requires adequate funding to fuel this.

Orchestration drives the leveraging stage of the IT-driven patient agility and digital transformation framework, focusing on establishing disciplined, rigorous, and consistent sensing and responding capabilities. This study shows that developing strong patient agility capabilities is essential to providing high-quality and flexible medical services. Hence, these adaptive sensing and responding capabilities need to be cultivated through a carefully designed and executed approach to organizational change and transformation. This process requires a high engagement planning process with an extended department leadership team and a rapid cascade process for all physicians, nurses, management, and other medical providers to build understanding, ownership, accountability, and alignment.

In this stage, it is vital to develop the appropriate structures and systems to establish patient agility and facilitate its evolution over time while balancing the tensions between formal and informal structures and systems. Understanding patient agility performance by analyzing specific past experiences and the root causes of successes and failures is also crucial in this stage. Moreover, hospital departments should change the organizational and departmental culture and capabilities. Effective change campaigns simultaneously focus on changing individuals’ behavior and institutional departmental features in clinical practice. The transformations that the hospital department launches should be introduced with care and in alignment with the strategic direction to be successful.

Decision-makers should reinforce rapid alignment across physicians and other medical providers, with specific commitments from all staff that become the backbone of the drive towards agility. By leveraging IT applications and knowledge processes in clinical practice, physicians can attempt to discover patients’ additional needs and extrapolate key trends for insights into what patients will need in the future. This process should go hand-in-hand with the simultaneous configuration of electronic medical records or even dedicated clinical decision-support software that enables physicians to work with the system to make informed and accurate decisions concerning diagnosis and treatment. In this way, hospital operations and clinical pathways are organized to enable physicians and (specialized) nurses to react to patient needs and demands and respond to changes in the patient’s health service needs. Consequently, the patient treatment process and medical quality services can be enhanced.

The final stage, i.e., monitoring value, is all about measuring and acting upon what is measured. The focus should be explicitly on linking metrics upwards, downwards, and even laterally to create a monitoring system that enables learning about the interdependencies and interactions in the hospital department. The metrics should be drawn from strategic objectives and re-enforce learning about patient service and (cost-)efficiencies; incorporating this learning into the metric system is critical to continuous improvement. The monitoring system serves as a credible guide to action in clinical practice. Identifying linkages provides physicians and department managers a clear line of sight regarding how their metrics relate to other departments, even beyond the hospital’s boundaries, making the implications of various choices and actions explicit.

Initially, the focus should be on a limited diversified set of the hospital department’s long- and short-term goals to initiate such a system. However, going through the first stages, i.e., orchestration and leveraging, is critical and enables the transformation’s success without limiting the departments’ responsiveness and ability to adapt to change. Moreover, detailing the roles, tasks, and responsibilities in daily practice is essential to ensuring an aligned strategy.

This stage is essential for hospital departments that want to deploy their resources against future strategic objectives and the ambition to develop a what-if ability to look ahead. Finally, the monitoring system should be flexible, allowing for easy revision as the health landscape changes.

In this stage, but also throughout the other stages, strong communication can increase excitement about enhancing clinical processes and strengthening the quality of the services. Motivated leadership is required to drive the transitions, and multidisciplinary teams (involving physicians, nurses, and other medical providers) should drive improvement initiatives. This stage is a crucial reinforcement of the previous stages, ensuring that a feedback loop is established, and a continuous improvement is implemented within the hospital department.

It should be acknowledged that the achievement of a high patient service performance and market performance stems from the specific interplay between IT ambidexterity and patient agility within the rapidly changing healthcare ecosystem. This means that performance enhancement depends on the various contingency elements that are considered when formulating an improvement strategy ^[11][12]. 

Our results support the theorized model and the subsequently developed IT-driven patient agility framework and illuminate how to transform clinical practice and drive patient agility.