Digital transformation assessment and future challenges with special reference to Covid 19.

1. Digital Strategies
Covid 19 in Context
Babu George, PhD, DBA, EdS.
Professor of International Business & Associate Dean,
School of Business, Christian Brothers University, USA
www.cbu.edu

2. What is a
Digital
Strategy?
Digital strategy is about
strategically using digital
technologies to create or
improve value for the
business stakeholders.

3. Being
Digitally
Smart is at
the Heart of
Industrial
Revolution 4
• Source: https://transportgeography.org/?page_id=1363

4. Key Technologies
Driving Industrial
Revolution 4.0
• Simulation: Reduces test cycles before introducing new products
• Autonomous (Ro)bots: They will co-work with humans, taking over complex
assembly line work.
• Additive manufacturing (rapid prototyping, 3D printing): These technologies will
take product customizations to the next level.
• Significantly improved co-production between buyers and sellers
• Smart Clouds: Clouds will have processing power, in addition to storage capabilities
• Internet of Industrial Things: IoT is already popular in the consumer realm. It will
be used extensively in industrial applications.
• Big data analytics: For big, timely, insights.
• Cybersecurity systems: More sophisticated security systems will (have to) come up
to protect a society built around data and networking.
• Augmented Reality: This will amplify human sensory power
• Blockchains: Decentralized digital infrastructure, smart contracts, a way to
authenticate originality
• Cryptocurrency: Possibility to be “free” from governments and bankers
• Brain-Machine Interfaces: Brain-machine interface technology inserts tiny
electrodes into the brain and then lets brain and computers communicate directly
(E.g. Neuralink).
• Satellite Internet Systems: Starlink like companies have the ambition of providing
worldwide high speed internet via satellites

5. The Still Unfolding Landscape
Source: https://www.thegeniusworks.com/2017/07/disruptive-technologies-exactly-applications-mean-business/

6. Digital Strategy
Drives an
Organization’s
Digital
Transformation
Efforts
• Digital transformation is a process in which
disruptive digital technologies open up additional
opportunities for dynamically capable organizations
seeking to improve the ways they create value and
these organizations strategically exploit such
opportunities by altering their structures, processes,
and cultures within the degrees of freedom afforded
by the aforementioned technologies.
Source: George, B. (2020). Introduction: Digital
Transformation of Business and Societies. In George,
B. and Paul, J. (Eds). Digital Transformation of
Business and Societies. Palgrave McMillan.

7. Source: Vial, G. (2019). Understanding digital transformation: A review and a research agenda. The Journal of Strategic Information Systems, 28(2),
118-144.
What does it Mean to be Digitally Transformed?

8. Digital Transformation is a Change
A change
A change in tools that
organizations use
A change in processes
that organizations use
A change in people that
enlivens organizations
A change in
organizations
themselves
A change in
organization’s
engagement with actors
in the external
environment

9. Two Central “Digital
Dimensions”
Use of digital technologies to
increase efficiency of existing
processes
Use of digital technologies to
create new “scope
expanding” processes, new
products, new services, and
new business models.

10. Yet, the Non-
Technology
Dimension is no
Less Important!
• Within organizations, digital strategies
imply a shift to big data, analytics,
cloud, smart mobile devices, social
media, improved uses of legacy CRM /
ERP services, etc. (in the current
iteration!).
• Yet, it is not only about technologies
• It is also about managing the
human side of organizations for its
corresponding transformations
• Success of technology
strategies depend upon
internal and external
consistencies

11. Three Major Phases of
Digital Transformation
Source:https://sloanreview.
mit.edu/article/digital-
transformation-on-purpose/

12. Source:
https://www.briansolis.
com/2017/01/definition
-of-digital-
transformation/

13. Organizational Levels and Digital Strategies
Corporate strategies
typically lay out the
visioning for digital
future for
organizations
Digital strategies find
their most common
places at the business
and the functional
levels

14. Why Digital
Strategies?
• Need to be cheap by reducing costs
• Allows the automation of complex yet repetitive tasks in more
efficient ways
• Lowered transaction costs
• Need to be truly special by differentiating (mass customization)
• Allows combining product and service segments in creative
ways to make unique products and services
Increased competition
• “Electronic submissions NOT accepted” (2000) to “ONLY
electronic submissions accepted” (2020)
Regulatory pressures
• E.g. Use of blockchain technologies to verify the authenticity of
information
Increased expectations about accountability

15. Why Digital
Strategies?
• Changing customer, employee, and supplier expectations
• Digital transformation gives access to improved insights on customers and
suppliers
• Allows real time data driven “smart” response to their needs and
expectations
• Offers the ability to anticipate in more realistic ways and be ready
for the future
• Opportunities to enter new markets without having physical presence
• Use e-commerce to effectively reach foreign markets
• Going digital is widely considered to be a futuristic investment
• Or, this is just as a way to overcome digital illiteracy
• Or, may be there is no other way!! (Covid-19!)

16. Why Digital Strategies?
It is a way to embrace the Neo-Normal Consumers!
Digital technologies profoundly
changed consumer behavior
They are no longer passive recipients of what sellers offer!
They are not captivated; they can search and find alternatives!
They express voice and expect their voices be heard!
Co-funding, co-design, co-production, co-marketing, and co-distribution

17. Source: https://mitechnews.com/guest-columns/a-look-at-digital-
transformation/
Successful Digital Strategies Create and Tap into a “System of Intelligence” in Organizations

18. Digital Strategies for the Digital Non-Natives
• Sometimes, existing incumbents have insurmountable disadvantages over the
newcomers when it comes to digital transformation.
• These digital immigrants may make their death a bit slower
• The Case Study of Thomas Cook
• Once, world’s No.1 travel agent and tour operator
• Digital technologies disrupted the travel industry.
• The birth of Expedia as a digital native.
• Thomas Cook absorbed some of these technologies to complement their
existing operations
• Still could not survive; finally closed shop in early 2020.
• Currently, legacy bankers are embracing blockchains and crypto-currencies.
• Will they avert the Thomas Cook situation?

19. Should Digital
Strategies be
“Standalone”?
• Should digital and business strategies be in alignment?
• Or, going one step further, should they be fused?
• Fusion makes it organic
• Digital strategy is not merely a supportive
process but is at the core of the “logic of the
business”!
• The downside? It makes these two realms entrapped to
each other!
• Reducing potential for independent innovations
in these realms.
• A curious case of synergy killing creativity?
• Regardless, ambidexterity is very important as a
general concept

20. The Covid 19 Version of Digital Transformation
(Is this truly DT?)
• The emergence of the company website as the new front office
• Of course, often with an “apology” for not opening the physical shops!
• Telework
• Use of digital communication tools for texting and calling
• Drastically decreased use of traditional “phone calls”
• Increased use of social media to reach customers

21. The Covid 19 Version of Digital Transformation (Is
this truly DT?)
• Digital workflows
• End of “paper” use but rather use digital versions of document approval
processes
• Use of cloud storage of files in sharable / collaborative ways
• Use of digital teamwork solutions such as WebEx Teams and MS Team
• Increased acceptance of SaaS (Software as a Service)
• Increasing consumer preference for digital versions of products and services
• Telemedicine, electronic books, etc.

22. The Covid 19 Version of Digital Transformation
(Is this truly DT?)
• Increased understanding of the need to have technologies, both internal
and external, that “talk to each other” (interoperability).
• The realization of needing a “center point”, a single interface that can
tap into various processes and workflows.
• A surprisingly greater willingness of organizations to accommodate
employees who are technology laggards!
• Serendipitous recognition of new product and market opportunities
• The emergence of “Tech Support Guys” as lifesavers! IT is no longer a mere
“support service”.

23. Key Learnings from Covid 19
Make everything smart,
make everything an
“internet of things”!
1
Make everything
connected to the cloud!
• Make information security
and privacy important
priorities!
2
Have a plan and budget
allocation, even if it
does not work!
• Prevent scope creep and
empty coffers!
3
Invest in gathering the
big picture by big data
analysis!
4
Invest in people and
their technological
skills!
• Make training materials
available and accessible!
5

24. Key Learnings from Covid 19
Integrate ML and AI into
business processes, even
when no immediate
advantage!
1
Identify opinion leaders and
make them digital
evangelists!
•Let hierarchical leaders not merely
preach but also practice digital skills!
•Invest in some redundant
technologies!
2
Not have too many
concurrent change initiatives!
•Change overload syndrome!
3
Have matrices to measure
success, but also mindful that
short term success is not the
goal!
•Use feedback loops for continuous
improvement!
4
Use “audience appropriate”
and “purpose appropriate”
communication /
collaboration styles
5

25. Make your
Organizations
Crisis Proof!
• Nurture within your organization, within each of its
division, a small group of employees to experiment
with promising technologies and tech-enabled
processes
• Encourage them to present these Endogenous
Opportunities to others within the organization
and get buy-in from key decisionmakers
• These employees should be treated as boundary
spanners
• Institute a process to absorb these technologies in
organic ways
• Organizations that do not do this are doomed to face
technological onslaughts as Exogenous Threats
• Prevention is better than Cure!

26. Leadership for Crisis Management
• We need to have leaders who identify and act on both of the following:
• Threats from the crisis
• Opportunities after the crisis
• There are many ways to deal with a threat; will the way you choose to
deal with a threat make you more competitive once the threat is gone?

27. Leadership Lessons from Covid-19
• We need to have leaders with Dynamic Maturity
• Static Maturity: The state of mind that allows one to maintain calmness and make right decisions in
complex yet repetitive situations. A capability that comes as a result of having experience with similar
situations in the past.
• Dynamic Maturity: The state of mind that allows one to maintain calmness and make right decisions in
complex and novel situations. This is an emergent capability that comes primarily as a result of having
experiences with diverse kinds of VUCA (Volatile, Uncertain, Complex, Ambiguous) situations in the
past.
• It is NOT enough to have agile leaders.
• Agile leaders can navigate complexities but the jolts they create in organizations often are
unbearable.
• Dynamically capable leaders are like those airline pilots who successfully deal with sudden
turbulent events while keeping the plane, the crew, and the passengers with the least amount of
discomfort.
• Note that the capability of the plane (organization) is also a factor here.

28. Telehealth: A
Case Study on
Digital
Strategy
• Telehealth has been playing a progressively
major role in the management of the NCOVID-
19 crisis.
• The enforcement of social distancing measures
has had the consequence of reduced
technology distance in almost every walk of life,
not just in healthcare.
• Covid 19 made telehealth finally come of age!
• It is time to move it from the peripheries to
the center of the 21st century healthcare.

29. Telehealth in
the NCOVID-
19 Context
• Available anecdotal evidence indicates that telehealth did play a surprisingly
stellar job in early diagnosis and the continuous monitoring of symptoms
while the patient is held in isolation or quarantine.
• As a result of NCOVID-19, social distancing measures were advocated
globally.
• Telehealth procedures, by their very nature, are a natural partner to
the enforcement of these measures in the clinical settings
(Ohannessian, Duong, & Odone, 2020).
• In China, surprisingly, the government had invested heavily in an Emergency
Telemedicine Consultation System (ETCS) and this quickly kicked in to
complement the brick and mortar healthcare facilities (Zhai, et al., 2020).
• Countries like Israel and Japan have used telemedicine to provide care to
infected passengers stranded on cruise ships for multiple weeks.
• Infected sailors on the US Navy ships too received extensive telemedicine
support. At least ten US navy vessels reported significant outbreaks recently.

30. Telehealth in
the NCOVID-
19 Context
• In the developing economies of Asia, telemedicine has come a long way.
• From store-and-forward (Brandling-Bennett et al, 2005) email-based
diagnostic in remote rural areas of Cambodia (Heinzelmann et al, 2005)
to the development of smart NCOVID-19 helmets with a Mounted
Thermal Imaging System that measures temperature in Indonesia
(Mohammed et al, 2020) and a social media ecosystem based NCOVID
software to report symptoms in Vietnam (Nguyen et al, 2020).
• In general, the consumer directed supply chain leveraged by many hospitals
during the NCOVID-19 made it possible for patients to be pre-screened
remotely for symptoms and for gathering evidences such as travel history
(Zhai et al., 2020).
• Screening algorithms powered by AI did most of these without much of
direct human intervention.
• According to the likelihood scenarios and other constraints, the bots
would then intelligently schedule patients to either hospital on-
premise facilities or to a live video conference with physicians.
• Prevention or identifying the symptoms of the disease during early
consultations is probably the most rightful use of telehealth.
• It does sound like this is the main direction telehealth is currently
being used amidst the pandemic (Gao et al., 2020).

31. Telehealth in
the NCOVID-
19 Context
• Deployment of mobile and e-ICU systems increased the efficiency of the
system multifold.
• Although experimentally, some of the hospital systems even used self-
driving vans as mobile units.
• A couple of physicians could monitor day and night a hundred or more
patients simultaneously, thanks to the electronic distribution system made
possible by interconnecting these smart units.
• If there is a situation involving numerous physicians being quarantined
for possible infections, this could be the only workable last resort
solution.
• Even with limited deployment, earlier indications are that telehealth has
helped significantly to preserve valuable personal protective equipment.
• According to popular media reports, many hospital systems that did not have
these technologies and associated infrastructure collaborated with others to
benefit from them.
• Complementary systems such as the ETHAN (Emergency Telehealth
and Navigation) originally being used by the Houston fire department
were repurposed to better serve in the current crisis.

32. Telehealth in
the NCOVID-
19 Context
• Social media technologies could be repurposed to play a central
role in the communication function (Menon & George, 2018).
• In the light of the lowered thresholds of HIPAA compliance as
a result of COVID-19, communication tools built around
consumer-oriented platforms such as Skype, FaceTime, Google
Hangouts, etc. were used heavily for initial consultations.
• Deepak et al. (2020) narrate how dermatologists in India
use WhatsApp for consultations these days.
• A plethora of medical specialties have capitalized on remote
treatment, including reports of smartphone based ocular imaging
for eye care (Naga et al, 2020), iPads for telepalliative care
(Humphreys et al, 2020), virtual management with online
instructions for urology infections (Grimes et al, 2020), a portal for
pediatric patients (Patel et al, 2020), video telemedicine for stroke
services (Markus & Brainin, 2020), and remote triage lines for
cancer patients in Indonesia (Brahma, 2020).

33. Telehealth in
the NCOVID-
19 Context
• In mental health, the NCOVID-19 pandemic has spun new
fields such as telepsychiatry, telepsychology, teletherapy and
teleneurology in e-consulting technologies are used to treat
patients (Klein et al, 2020).
• Online counselling of hidden youth (i.e. withdrawn
from school and social activities) in Hongkong had
better therapeutic outcomes than traditional
offline methods due to anonymity, fit with lifestyle
and more power balance (Chan et al, 2020),
although still less effective than integrated delivery.
• For substance related treatment in the context of NCOVID-
19 disruptions, doctors are no longer bound by the Drug
Enforcement Administration’s requirement for face-to-face
assessment and prescription, which led to growth in live
interactive video communications to assess and medicate
ADHD youth (Knopf et al, 2020).

34. Telehealth in
the NCOVID-
19 Context
• The NCOVID-19 crisis also brought in the widespread realization
that the Internet is an essential utility.
• Thankfully, most government subsidized cellular plans for the poor
users in the US have recently increased free data limits.
• However, currently, there is no guarantee that everyone has in
their possession a smartphone with the basic technical
specifications needed for effective consultations with
healthcare providers.
• Another reported challenge is language barriers for the non-
native speakers of English.
• Better integration of the telemedicine technologies with
real-time translation software could become handy in
such situations.
• One of the doctors we talked to recommended a patient
to communicate with the help of Google Translate, which
did not work well. Later, a human translator needed to be
found from among the hospital support staff.

35. Telehealth in
the NCOVID-
19 Context
• The US has proved itself to be a laggard in the deployment of
telecommunication technologies for supporting telehealth.
• To give some contrast, in China, companies like Huawei, ZTE, and China
Telecom came together to interconnect the hospital-to-hospital layer
of their telemedicine system with 5G technology.
• In mid-February, Singapore had deployed a GPS tracking system to
identify and report those under quarantine.
• Taiwan’s government made proactive use of big data to cross-reference its
national health insurance database with its immigration and custom
databases and trigger alerts on a patient's travel history (Lu et al, 2020).
• In contrast, it took so much more time for Apple and Google to come
up with an interoperable contact tracing app in the US, albeit with
much less features.
• It must be noted that the deficiencies in the US system are more
related to concerns about privacy and individual liberties rather
than the lack of technological knowhow.

36. 36
A high-tech giant, South Korea developed a
comprehensive trace-test-treat system
including police records, credit card data,
transit pass records, CCTV footage and a
mobile phone proximity app which alerts
passers-by to the presence of nearby
patients (Park et al, 2020).
Telehealth in the
NCOVID-19 Context –
The South Korean
Example
Source: Park et al, 2020. Retrieved 23rd April, 2020 from
https://jamanetwork.com/journals/jama/article-abstract/2765252.

37. TELEHEALTH IN THE NCOVID-19
CONTEXT
• The seamless coordination of testing centers was vital in maximizing the
efficiency of testing.
• Networking among hospital systems helped further this goal.
• Yet, true interoperability among these systems was found to be impossible,
given the differences in the environments each of them developed.
• In the US, Aurora Health, Cleveland Clinic, Jefferson Health, Kaiser Permanente,
Mount Sinai, and Providence, all have their own in-house systems and models.
• The current crisis points to the need of integrating these systems in a tighter manner.
• The silver lining was, although these technologies were not being heavily used in
the past or not interconnected for the best efficiency, those were available still
for relatively quick deployment in the crisis situation (Chauhan et al., 2020).
37

38. TELEHEALTH IN THE NCOVID-19
CONTEXT
• The lack of short and easy to understand training programs such as videos
and user guides is something that needs to be quickly addressed.
• Agencies like the American Medican Association (AMA), National
Consortium of Telehealth Resource Centers (TRCs), and the Centers
for Medicare & Medicaid Services (CMS) has catered well to the
former part.
• Telehealth technology developers too contributed heavily to
documenting practice implementation, policy, coding, and payment
methodologies.
• The AMA Physician Innovation Network organized several webinars on
telehealth deployment for the benefit of the physicians, too.
38

39. TELEHEALTH IN THE NCOVID-19
CONTEXT
• The panic created by an unexpected surge for resources in the US also meant patients
would seek consultations with remote healthcare providers located abroad.
• Most patients did this with the knowledge that consultations or purchases made this
way would not qualify for insurance benefits.
• They also seemed to embrace the risk of receiving advise from non-board-certified
physicians and getting medicines shipped from unverified sources.
• I hope, in the post-COVID era, the regulatory system will expand its reach, not to
restrain overseas consultations or treatment but to ensure that these players function
within the broadly held parameters of the US healthcare system.
• This could also help with healthcare quality assurance, secure transmission and
upkeep of patient records, and bringing down costs.
39

40. LEARNINGS ABOUT DIGITAL STRATEGIES FROM
THE TELEHEALTH CASE
• The NCOVID-19 crisis threw telehealth into a situation akin to some parents tossing young kids to the ocean
expecting them to quickly master swimming.
• In a typical planned deployment scenario, there would have been numerous rounds of pilot testing and
simulations before using it extensively.
• AlDossary, Martin-Khan, Bradford, & Smith (2017) observe that most telemedicine projects have a
poor record of qualifying beyond the trials, based on clinical outcome, economics, or patient
satisfaction.
• Many of the actual uses of telehealth currently are kneejerk reactions that would probably not have
passed testing phase.
• Although not in anticipation of a pandemic, some countries did extensive testing of their telehealth
systyems.
• Norway’s “Telemedicine Agder” is one of them: this project, through simulated experiments,
studied the implementation of large-scale telemedicine deployments and identified successful
service models (Smaradottir, Fensli & Moe, 2018).
40

41. LEARNINGS ABOUT DIGITAL STRATEGIES FROM
THE TELEHEALTH CASE
• Although I discussed at a great length on technologies, it must be recognized that lack of high end
technology is not the main barrier for further long-term adoption of telehealth.
• Highlighting the example of the Catalonia region of Spain, Centelles (2020) observes how even
a plain old vanilla technology like telephone calling could supplement with traditional
consultations and thereby ease the hospital resources for more serious cases.
• Bottlenecks to telehealth are more about governmental licensing regulations and the attitudes of
middlemen such as health insurance companies, particularly in the US scenario.
• While public funded healthcare systems in certain countries do not have any motivation to innovate
(George & Salgaonkar, 2006; Mekoth, et al., 2012), crises like NCOVID-19 are great exogenous forces
that can shackle any resistance to change.
• In the US, some commercial health insurances companies had already agreed to reimburse remote
consultations.
• Although on a temporary basis, the Centers for Medicare & Medicaid Services (CMS) in the US
has taken an unusually positive stance, in the NCOVID-19 situation.
• The 1135 Waiver issued meant hospitals could code e-consultations as regular patient visits and
get insurance companies to pay for the visits from Medicare.
41

42. Concluding Thoughts: Thinking Style to Lead in the Digital
Era
• Convergent, holistic, thinking made “the wise men” of the pre-industrial times.
• From the early ages of industrialization, divergence began to be the norm.
• A world of specialists.
• Industrial revolution 4.0 brings back a new kind of convergence / integration
• The convergence of the physical, psychological, and the biological dimensions by means of data
and networking technologies
• Nano-specializations exist and thrive, but those all work together quite seamlessly.
• Organizational hierarchies and silos disappear
• This allows new ways of thinking and doing

43. Concluding Thoughts: Ethical Directives for the
Digital Strategizers
• Avoid increasing the Digital Divide
• Find ways to be inclusive!Avoid
• Be mindful of the dangers of “insensitive”
Algorithmic Decision Making
• Be humanistic!
Be

44. Thank you!
Connect with me at www.linkedin.com/in/beingbabu