Applying change models and methods during a period of vast digital transformation: a systematic review of practice in healthcare

Reflection and learning about the use of virtual care in healthcare delivery has become a central goal for health systems internationally. Insights drawn in the aftermath of the COVID-19 pandemic have led to vast changes to embed virtual care in health care delivery. This study explored the methodologies used to manage change that encompasses virtual care and factors contributing to success. Methods: A systematic review and narrative synthesis was undertaken. Eligible articles were those reporting structured change management processes in the context of virtual care published between 1 st January 2019 –31 st December 2023, identified by searching four electronic databases (Scopus, MedLine, PsycInfo and Business Source Premier). Data were extracted and synthesised from the eligible studies. Results: A total of 17 articles were included; studies focused on changes occurring within hospital settings and in community health centres, often within a single organisational unit, institution, or hospital network. Studies described using various methodologies for managing change during the introduction of large digital systems, embedding new digital tools, the introduction of new technologies and workflow or process design changes resulting from virtual care. Discussion: Structured change methodologies were often integrated in a strategic change framework with process improvement methods utilised to support the change process. Managing change relating to the technology with attention to the clinical and people aspects of change was considered a key gap and challenge in the context of virtual care change. Change leadership and the integration of technical and clinical teams were identified as key enablers.