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Understanding cultural differences - a key component for accelerating systems implementation processes

'Cultural differences' is a complex concept. It includes the differences in beliefs, values, behaviors, and the way people understand their world. In medicine - In the multicultural and hyper-technological age we live in, understanding cultural differences is essential to the success of adapting new medical technologies.

Despite the common perception that hospitals are an "objective" space that should not be influenced by "culture" - today we understand that local culture has a great significance in shaping our medical environment.

The ICU4Covid project aims to implement the CPS4TIC system in ten intensive care centers across Europe (consisting of a number of central and peripheral hospitals) that will form the basis for increasing the scale of future use of the system. The CPS4TIC system is a cyber-physical system for communicative medicine and intensive care that has the power to contribute to an effective and successful connection between intensive care units, both at the national level and at the level of the entire European continent. As part of the project planning, the various assimilation teams made a great effort to prepare themselves for the important cultural differences in the various health centers. Even now, we still want to learn more about the cultural complexities that exist in the various countries participating in the project - with the aim that it will help us to sustain this project in the best possible way.

The first four treatment centers are located in Portugal, Greece, Germany, and Austria. Although there are many similarities between intensive care units there are many differences between them - in the geographical distribution, size, degree of digitization, and their experience with telemedicine technologies and connected processes - these differences are a significant factor influencing the system implementation experience within them. These differences are reflected in the digital administrative level - in the geographical distribution, in size, in the degree of their digitization, and in their experience with telemedicine technologies, etc. And at the cultural level - patient access, therapist-patient relationship, acceptable waiting times, adoption of new technologies, response to specific needs, etc.
Already at the design level, it was clear that these differences would be a significant influencing factor in the experience of implementing the CPS4TIC system within the various medical centers. Therefore we had to be culturally sensitive from the preparation stages.

As is the case in many hospitals around the world, the successful implementation of advanced systems promises a more efficient, fast, and connected future. But a successful process cannot exist without conforming to local norms and needs.

Cultural differences can be subtle, for example, the relationship between the therapist and the patient - in many places in the world it is customary for patients to be accompanied by an attendant, which makes the relationship between therapist and patient one involving another person. Another example of a subtle cultural difference could be access to digital tools - in a culture where there is an older population, access to personal technological tools will likely be more limited - affecting people's independence in medicine, such as accessing medical data or even making appointments.

Cultural differences are a dramatic component in any international project, especially in ICU4COVID-type projects, which are designed to try and reduce response times and access to global databases.

ICU4COVID sought to be a learning project from the beginning with cultural sensitivity at the forefront of its endeavors. Understanding cultural differences and being able to identify them in advance allows for quick access, an effective, reliable connection and relationships with few disruptions and gaps in understanding. The inclusion of cultural differences makes it possible to make the various tools accessible and to face challenges from a sensitive multicultural perspective.

More lessons we learned

Digital transformation of medical centers is not a one-time event #3

Digital transformation is a change that is advancing in waves driven by technological advancement and the accessibility of innovations. 

Lessons Learned from a Social Science Perspective #6
Technical Infrastructures Need to be Accompanied by Social Models of Telemedical Care  
one of three lessons written by our partners at the University of Vienna

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