## 5 Comparison and Discussion: Towards the Lever of the GOLD Approach
### Enabling the Lever of the GOLD Tool to Improve the Status Quo  
When evaluating the status quo of the healthcare and hospital systems with respect to managing today's IT challenges and the ensuing digital gap, it becomes evident that irrespective of the hospitals' employment of high-tech equipment, they are anything but process-driven, patient-centered, or interface-oriented. Instead, today's digital reality shows that hospitals consist of specialist silos, strict hierarchies, and inside-out expert focus, which create an ecosystem of non-cooperation, non-communication, and non-compliance with overall values. Thus, in Germany, digitalization is not a matter of technological constraints; it is a matter of people, power, and politics. Therefore, hospitals still embody the crucial elements of craftsman organizations, which do not live up to the advanced industrial flow principles as first implemented by the famous Japanese carmaker Toyota [44]. Here, digital tools and technologies significantly increase the pressure to act by speeding up processes, ensuring systemic connectivity, and making activities leaner, smarter, and more efficient [45]. To move the healthcare system to the next level, it must think, collaborate, and act in a more holistic fashion. To achieve this, it must address the following five aspects:  
1. Hospitals must rigorously detect IT and digitalization gaps through audits. 2. Hospitals should employ holistic navigation systems such as the GOLD Tool to delineate interfaces, interdependencies, and interdisciplinary fields of cooperation. 3. Digitalization is not only a matter of hardware and software but also of brainware and peopleware. All too often, people and cultures resist digital progress due to change-blocking path dependencies and legacies of age. 4. Hospitals must give digitalization a seat at the strategic table by creating a C-level position in the shape of a chief digital office [46]. 5. The GOLD Tool is no mantra or silver bullet, but a platform-based integration tool for creating a connected ecosystem of concerted and consigned action. Thus, the more it gets integrated into the existing (interconnected) IT infrastructure, the greater its lever and its possibilities for support. Generally, the GOLD Tool serves as a holistic platform to create a holistic IT landscape by connecting and aligning people, systems, and hardware solutions by means of a one-thing approach. The GOLD Tool propels intra- and interdisciplinary cooperation and coordination of value-generating activities among involved agents. It could serve as the initial starting point to overcome parochialism in hospitals because formerly protected fiedoms have become digitally connected. The GOLD Tool goes beyond technological gimmicks to bridge interests and disciplinary buffer zones. The one-health approach standsfor service alignment since a single interface with a patient is anything but a lived reality. The GOLD Tool application in hospitals depends on five critical success factors:  
_Technical support:_ The GOLD Tool must be implemented from the service engineering point of view. Technological obstacles should be overcome with respect to systems' integration and embeddedness. _Leadership support:_ Management innovations such as the GOLD Tool should be promoted by C-level agents. The chief digital officer or chief information officer could have a strong bearing on tool implementation. _Financial support:_ Digital change is not a free lunch but depends on financial aid and budgeting. Digitalization resembles a strategic investment, not a burden. The financial return on investment in the GOLD Tool could be very substantial due to better, smarter, leaner, and faster asset utilization in healthcare. _Platform acceptance by ease of use:_ The GOLD Tool reaches the tipping point of success if it is convenient, smart, and accessible. In hospitals, medical consultants are important change agents and thus should adopt the role of positive storytellers.