Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Jun 14, 2021)
Date Submitted: May 29, 2021
Open Peer Review Period: May 29, 2021 - Jun 14, 2021
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Benefits realisation management in the context of a national digital transformation initiative in English provider organisations
ABSTRACT
Background:
The Global Digital Exemplar (GDE) Programme is a national initiative to promote digitally-enabled transformation in English provider organisations. The Programme applied benefits realisation management techniques to promote and demonstrate transformative outcomes. This work was part of an independent national evaluation of the GDE Programme.
Objective:
We explored how benefits realisation management was approached and conceptualised in the GDE Programme.
Methods:
We conducted a series of 36 longitudinal case studies of provider organisations participating in the GDE Programme, 12 of which were in depth. Data collection included a combination of 563 semi-structured interviews (with implementation staff in provider organisations, national programme management staff, and suppliers), 389 documents (of national and local implementation plans and lessons learned), and 217 non-participant observations (of national and local programme management meetings). Data were coded drawing on a sociotechnical framework developed in related work and thematically analysed, initially within and then across cases, with the help of NVivo 11 software.
Results:
Most stakeholders broadly agreed with the rationale of benefits realisation in the GDE Programme to show due diligence that public money was appropriately spent, and to develop an evidence base supporting the value of digitally-enabled transformation. Differing national and local reporting purposes however created tensions. Central requirements for progress reporting and tracking high-level benefits had limited perceived local value and were perceived to impose an unnecessary burden on provider organisations. This was accentuated by the lack of harmonisation of reporting requirements to different stakeholders (which differed in content and timing). There were tensions between the desire for early evidence of outcomes and the slow processes of infrastructural change (which created problems of attribution) also between reporting immediately visible local changes and showing how these flowed through to high level organisation wide benefits (e.g. in terms of health outcomes or cost savings/return on investment). The attempt to fulfil these diverging agendas and informational needs within a single reporting tool had limited success. These difficulties were mitigated by efforts to simplify reporting requirements and to support targeted collection of key national outcome measures. Although progress was hampered by an initial lack of benefits realisation expertise in provider organisations, some providers subsequently retained these skills for their own change management purposes.
Conclusions:
There is a need to recognise the limitations and cost of benefits realisation management practices. Prior agreement about rationales for collecting information and a more targeted approach to tracking local and high level benefits may enhance local relevance, reduce perceived reporting burdens and improve acceptance/effectiveness.
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