The document discusses digital transformation in Norwegian government through an ehealth project called Telma, which focuses on telemedicine for chronic diseases. It highlights challenges such as stakeholder management, resource allocation, and project delays while emphasizing the importance of user involvement and governance for effective digital solutions. Preliminary findings suggest that organizational maturity and complexity hinder innovation, while AI and machine learning could enhance understanding of ehealth users.

1. Digital Transformation
in Government 3.0
Leif Skiftenes Flak, Professor
Chair of Department of Information Systems
Aug 1: Scientific lead of Centre for Digital Transformation

2. …challenges related to managing
increasingly complex transformation
efforts and uses examples from an
ongoing eHealth project in Norway…

3. Contents
• Norway
• TELMA
• Research approach and data
• Literature and theory
• Some headaches
• Preliminary findings

4. Norway
• Monarchy
• 5,3 mill people (2017)
• One of the richest
countries in the world
• Hydro power, oil and
gas, fisheries...
• One the most digitalized
countries in the world...

5. Agder
• Small region, with 2 counties, 30 munici-
palitites, and 300.000 inhabitants
• EIP AHA reference site on integrated care
• University of Agder, with 2 campuses
(Kristiansand and Grimstad)

6. TELMA – Telemedicine Agder
• Cooperation between
– municipalities,
– hospital,
– university
– vendors

7. TELMA –
developments
• Algorithms for
– COPD
– Diabetes
– Heart congestion
– Co-morbidity
are developed, tested and implemented
Users with mental health problems will also be included

8. Telma objectives
• Test and evaluate TM solutions for
chronic deseases and co-morbidity
• Good health services
• Reduction in use of health care
personnel

9. Pasient’s home
equipment
• This is the «electronic treatment»
Spirometry
Pulsoxymetry
HD video camera
Video
conference
speaker

10. TELMA – in use
• Patients monitor measurement and answer self-
assesment survey daily / weekly
• Videoconnection is set up with nurse regularly, or on
demand

11. User involvement
• User involvement can
not be over-estimated
• Usability lab
• Development
• Testing

12. TELMA research
• Benefit realization in complex e-health
projects
– Different stakeholders with different goals and
interests
• (Machine learning for COPD and diabetes
– Prediction of future status, decision support
for nurses
– «Self-service»)

13. Literature and theory

14. Literature on eHealth as background

15. Benefits Realization (Theory of the solution)
• Influenced by TQM
• Response to high IS/IT failure rates
• Limited empirical evidence
Ward, J., Taylor, P., and Bond, P. 1996. "Evaluation and Realisation of Is/It Benefits: An Empirical
Study of Current Practice," European Journal of Information Systems (4:4), pp. 214-225.

16. Research approach

18. Data so far
• More than 40 stakeholder interviews
• Observations
• Participation in project meetings and
activities
• Documents

19. Headaches

20. • What exactly is the IT artifact(s)?
• What is a sound division of
labour/responsibility between project
management and researchers?
• Health services allocated by different criteria
in hospitals and municipalities.
• How can we reach a common understanding
of how to transform services?

21. Preliminary findings –
problem definition

22. Enablers
• Enthusiasm and ownership
• Service quality
• Digitalisation /Innovativeness

23. Problem areas
• Project delays
• Recruitment of patients
• Questionable RIO
• Lack of resources
• Sustainable governance model
• Lack of understanding of consumers of
municipal eHealth users

24. Inhibitors
• National governance model
• Digitalisation
• Complexity
• Project organisation and
management

25. Suggested actions

26. Establish goal clarity
• Project goals should be communicated
clearly from project management
• Make a short memo on how the
services in Telma contributes to «good
quality» and reduced used of health
personnel resources

27. Improve stakeholder management
• Update the stakeholder analysis and
use this actively

28. Plan for
governance
• Establish a governance and funding
model for sustainable use after the
project period

29. Identify volume users of municipal
services
• Identify the characteristics of volume
users of municipal service users

30. Some preliminary takeaways

31. Organisational maturity slows down
innovation
Not a GOV 3.0 issue

32. Complexity slows down innovation
Potential GOV 30. issue?

33. Organisations may not be a useful unit
of analysis
Potential GOV 3.0 issue?

34. AI/Machine learning may be an
effective way to understand eHealth
users
Definately a GOV 3.0 issue.

35. Thank you