👾 Digitalization Is About Removing, Not Adding

I see so many people trying to “digitalize” a process without changing it one bit - just adding a few more steps here and there, which are done on a PC. After all, if we're using a PC, we're definitely digital, right? Right…

I even get why someone would consider doing digitalization in this way: they don't want to introduce too many changes. They don't want to have everyone learn a whole new process from scratch when they can learn just a couple of additional steps. Isn’t that practical?!

While I understand the intent, it beats the whole purpose of changing a process in the first place. The main goal of Process Re-Engineering is to make the process better in a way: simpler, faster, cheaper, smarter, more resilient, less risky, producing a higher quality end deliverable, and so on. Meaning, the result must be an improvement of sorts - especially since you'll be disrupting the business for it.

And if it's not going to be an improvement? Well, you know what they say: “If it ain't broke, don't fix it!” I'm pretty sure I know how this saying came to be 🙄

🫥 Digitalization & Automation

First things first: What is digitalization? It’s supporting an analog process with an IT system. If you only turn the process assets from analog to digital, that’s called digitization. For example, if previously you had to maintain a paper file in a physical folder on a bookshelf, now you can maintain a digital file (digitization) in a dedicated IT system (digitalization) in the cloud. In that sense, digitization is a necessary part of digitalization.

What is not digitalization? It’s not automation. Automation means that you convert manual steps of the process into technological ones - i.e., substituting humans with technology. For example, you receive an e-mail and then manually input the sender's name into a database. When you automate this step, the e-mail will trigger another IT system that will input the sender's name into the database without you having to do anything.

From these definitions, you might conclude that to automate a process, its steps must already be digitized. This is certainly convenient but it’s not a necessity, especially in sectors like manufacturing. We can automate a manual process without digitizing it first if we only improve the triggers (e.g., a conveyor belt moving products from station A to station B) or if we use machines to perform the process (e.g., robotic hands programmed to cook food).

Why is digitalization about removing, and not adding? Because improving a process requires us to a) look at it end-to-end, b) from the perspectives of all participants - and then we decide what we can digitalize. Technology makes our processes leaner, not more cumbersome, which is precisely why we use it. It saves us resources and speeds things up. So the more digitalization (and automation) we have, the better.

However, simply adding more steps to an existing process is not an improvement. Especially when those steps are digital, whereas before we had a fully working analog process - at best, they’ll act like a patch and use up more of our resources, and at worst, they’ll put us in ridiculously illogical situations and cause confusion and frustration among all participants.

Let me show you what this looks like in practice:

🖨 Digitalization in German Healthcare

A couple of months back, my health insurance card got blocked. Yet, I received a letter from my health insurer that if I had “acute illness”, I could still go to the doctor and they’d cover it. And sure enough, in the middle of winter, I got the flu.

My symptoms went progressively worse until one fine day, already having a terrible cough, I decided to see my GP. I went to the doctor’s office and explained my troubles at the Reception. The lady behind the desk asked for my health insurance card, but when she put it into her computer, it didn’t work - as expected. So, she told me I should call my health insurer and they’d fax her a certificate for me. She gave me the fax number, and I stepped outside the office to make the call.

My health insurer understood the situation immediately. However, they said they couldn’t send a fax (didn’t say why), but they could send the certificate to my healthcare app. Was I carrying my mobile? Yes, I was calling from it. OK, then they’d be sending the certificate to my app right away.

20 minutes later, that certificate still hadn’t arrived. I gave my health insurer a second call. Yes, they had indeed sent the certificate immediately after our call, but their system needed approximately 30-40 minutes to sync. I ended the call in dismay. I work in IT, after all. In this day and age, what IT system needs 30-40 minutes to sync?! If they had sent me the certificate via email, it would’ve arrived instantly. Even if they had sent me the certificate via pigeon, being in the same city, it would’ve arrived faster than 30-40 minutes.

Anyhow, 40 minutes after my call, the certificate finally arrived. I went back to the Reception and showed it to the lady on my phone - as I was instructed by my health insurer. However, she went into a full-blown panic mode:

“No!!!!! What is this??? I need the fax!!”

“But you said you wanted a certificate, and here’s the certificate,” I tried explaining.

“Nooo, I need the paper! THE PAPER!!!”

“OK, so if you give me your printer details, I can print it for you from my mobile.”

“We don’t have a printer!”

“You don’t have a printer?? Strange… Then how about I send it to you via e-mail?”

“We don’t have e-mail either!”

“What?! You’re at least five people in here right now, and none of you has an e-mail address?”

“No, we don’t have e-mail!!!”

“OK… So, what do you suggest I do now?”

“You have to print this! I need the paper!!”

“My printer is at home, and I don’t intend to go home to print it and come back, losing hours in the process.”

“There is a print café at the corner - go there, they’ll print it!”

“What print café at the corner? I haven’t seen anything like it.”

“No, there is one - go there and come back with the paper!”

I went out, walked two blocks, turned around the corner, and… there was a print café, indeed, but it was closed.

At that moment, I was seriously torn between two options: go back and do a big-mama scandal as only I can (because it shouldn’t be my problem that they can’t handle a digital file) OR walk around the city, sick as hell in the middle of winter, until I find another print café and get the damn paper. I decided to give the latter just one more try, and then revert to the former.

I pulled out my map, not even knowing what to search for. Internet café? That might not have printers, though. A print house of some sort? Maybe a bookstore? How is that even called in German?! I settled for a bookstore. The closest one was ten blocks away 😖

I arrived at the place. The bookstore was there. It was open. It had printers. But now I was up against challenge No.2.

I went inside and told the guy behind the counter:

“I have the following problem: I have a document full of my personal data, which is on my phone, and I need to print it. What are my options?”

“Well, you can send it to my e-mail and I’ll print it for you.”

“Yeah, but all my personal data is in it.”

“Ah, so you don’t want me to see it.”

“I don’t mind you seeing it, but I don’t want you to have it.”

“Well, another option is to send it to yourself, then use the computer the printer is connected to to log into your e-mail address, and print from there. Just don’t forget to log out afterwards.”

“Hmm, there’s also a third option: My phone can read a USB stick, and I have a USB stick, but I need a converter from USB-A to USB-C. Do you happen to have one?”

The guy went into a room behind him and came back with a USB-C stick.

“Ah, thanks! That’s convenient,” I said, taking the stick and porting it to my phone. I transferred the file to the stick and went to the printer. I could see the USB-A port of the printer, but not a USB-C one.

“Excuse me,” I turned to the guy again. “Where do I plug in the USB-C stick?”

“There’s a switch on the stick,” he told me. Before he finished his sentence, I saw a small button on the side, which hid the USB-C port and pulled out a USB-A one.

“Ah, yes, I saw it,” I said and placed the stick into the USB-A port of the printer. I navigated to my file, double-clicked… and the file didn’t open. I tried again, tried with different programs - nothing helped.

“Excuse me,” I asked the guy again. “I can’t open my file for some reason.”

He came to take a look and immediately saw that the file size was 0 KB.

“That file didn’t copy correctly,” he said - and he was right.

I pulled out the stick, switched from USB-A to USB-C, placed it in my phone, copied the file again, made sure it copied correctly, unplugged the stick safely, switched from USB-C to USB-A, plugged it into the printer, finally opened the file there, and pressed print. All three pages got printed. I could hear it. But I couldn’t see the pages anywhere.

I looked on the left side of the printer - no trays and no paper. Looked on the right side - again, no trays and no paper. Looked on the top (which I’d been looking at the whole time anyway) - there were trays, but no paper.

“Excuse me,” I turned to the guy for a third time, already laughing internally to myself - was I sure I worked in IT?! 🙈 “Where are those pages that just got printed?”

“In the middle,” he told me. “Just look in the middle.”

So, I had to lean down and look in between all the printer stacks to see a small horizontal opening. The pages couldn’t be seen, but when I placed my hand there, I could feel them. I pulled them out. Finally - success!!

I pulled the USB stick out of the printer… and at that moment, I remembered that my file was still on it. I switched from USB-A to USB-C, plugged it into my phone, deleted the file, removed the stick… and my phone crashed and began restarting, right before I could verify that the file was indeed deleted.

I put my phone in my pocket, switched the stick back from USB-C to USB-A, plugged it into the printer, opened it, saw no traces of my file anywhere, removed the stick, and gave it back to the guy. I also paid for my three pages - 0.25 EUR each; 0.75 EUR in total - and left.

An hour and a half later, after I first set foot in the doctor’s office that day, coughing like crazy, I entered it for the third time - and this time, I had the golden papers in my hand!

Here I have to make a small side note:
The doctor’s office had signs everywhere saying that face masks are mandatory, starting right from the front door. Naturally, I put my face mask on when I first entered and went to the Reception. However, when I said why I was there, the lady told me:
“I don’t understand anything - you’re wearing a mask!”
The fact that her English is not very good, and neither is my German, didn’t improve the situation. So, I removed the mask and said again what I had to say.
The second time I entered the place, the same thing repeated. I wore my mask, explained I now had the certificate, and she went:
“I don’t understand anything - you’re wearing a mask!”
Again, I removed my mask and repeated what I had said.
The third time I went in, I didn’t even bother putting the mask on. I went straight to the Reception to give her the printout. But before I could say anything, she looked at me, pointed at my face, and scolded me:
“You’re not wearing a mask!!”
So I put on my mask - on my chin! Because I had to have a mask on, but I couldn’t have a mask on 😵‍💫

“Here are the papers you wanted,” I said, beaming with glory. I handed them to the lady.

She took the papers, inspected each page, and got visibly relieved. I apparently had what was needed. Needless to say, I was way more relieved than she was.

“Thank you,” she said with a hint of a smile. “Just wait for a minute now; I’ll go to the other room to scan the document and I’ll bring it back to you.”

“Excuse me, what?” I was sure there must have been a mistake. “Did you just say you’ll scan those papers??”

“Yes,” she replied, confused. “I need to scan the papers now, and then I’ll give them back to you.”

“But I told you I had those papers in digital form,” I started yelling. I was sure I was going insane. “I could’ve sent them to you! In fact, I WANTED to send them to you!!!”

“No, but I needed the paper,” she started yelling back.

“Why? So you can scan it??”

“Yes, I have to scan it so I can put it into the computer! How else would I put it into the computer?!?”

😳😳😳

Make that make sense.

📃 Lessons Learned

You might think I fell between the cracks of an otherwise perfectly working process. That somehow I was the exception to the rule. I certainly thought that - and then I saw this video:

You cannot make this 💩 up: apparently, this is THE process. Someone had decided not to stir the muddy waters too much and just glued the last scanning step onto a process that has remained unchanged since the fax was first invented. And maybe it even works well in the eyes of those poor Reception ladies in the doctor’s office (why is 99% of them ladies, anyway??), who had to learn how to use a PC, a scanner, and the Internet - all in the last 20 years or so, and in no relation to the doctor’s profession whatsoever.

Has anyone looked at the end-to-end logic of this process? Clearly, not. Has anyone considered the patients’ (or even the health insurers’) perspective in this process? Clearly, not. Has anyone tested the process before rolling it out at full scale? Clearly, not. Is anyone collecting feedback for this process to identify opportunities for improvement? Clearly, not. So, all the basic Business Process Management steps have been skipped - for fax’ sake! - and yet, this process is still THE process being used? You bet!

~~~

To wrap this up, if you live in Germany, here are the lessons learned that might come in handy:

If your health insurance card is blocked, make sure you contact your health insurer well in advance, so they can send you a certificate instead - that’s at least 1 hour before you need to leave for the doctor’s office. (Note: You probably don’t want to contact them too early - although I don’t know what too early means; I assume a few days in advance - because then the doctor’s office might decide the certificate date is problematic. After all, that certificate is only issued because you have an “acute illness”, and that might be questioned if you’ve preplanned the event by a week or two.)
Once you receive the certificate, make sure you’re somewhere where you can print it out. Go to the doctor’s office only with the printout in hand.
In the doctor’s office, they’ll scan your printout and return it to you. Maintain your composure, especially if you work in IT. You have bigger fish to fry, and you won’t be able to change the whole country in one swift blow. Not today, at least.

Good luck!

BPMexplained🧩

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