Matthew Hickey and Suzanne Wait

Creating a digital-first health system, and why we aren’t there yet

23 March 2022

Creating a digital-first health system, and why we aren’t there yet

The past decade has seen a flurry of digital innovation in healthcare, but we must overcome structural barriers to realise the full potential of technology.

Imagine a world where your doctor doesn’t ask the same questions about your medical history, because all the information is in an electronic record. What’s more, if you see another doctor, they also have access to that information, as well as your previous doctor’s findings and advice. A world where, after a person with cancer finishes their last chemotherapy session, they are given (and taught how to use) a mobile app that allows them to record how they are feeling physically and mentally every day. They can also be comforted by knowing the information they submit is being sent to their clinical team, with a personalised algorithm raising an alarm if their symptoms indicate that something may be wrong.

Although unthinkable a few decades ago, this is now in the realm of possibility. The National Health Service (NHS) in the UK, like other health systems around the world, has recognised the innovative potential of digital technologies and set ambitious plans to become ‘digital first’, with the aim of offering seamless, continuous, data-enabled care.
 

Innovation accelerated during the pandemic

The COVID-19 pandemic accelerated the embedding of digital technologies and remote consultations into mainstream care, enabling continuity of care for patients and their clinical teams despite disruption to face-to-face clinical services. In addition, long-standing barriers to the use of telemedicine, remote monitoring and data sharing were stripped away owing to necessity and urgency. For example, legislation on reimbursement for remote consultations was rapidly revised so they could be offered to patients and appropriately reimbursed for clinicians.

Creating a digital-first health system, and why we aren’t there yet

Remote clinical support and monitoring have the ability to empower individuals to self-manage their condition, reduce emergency hospital admissions and improve outcomes.

 

Potential benefits for patients and clinical teams alike

The pandemic aside, digital health has flourished in the past decade. There are countless examples of truly transformative innovations, which will help global health systems deliver high-quality, timely, responsive care. The potential of digital technologies to aid the long-term management of non-communicable diseases is phenomenal – their benefits to patients, clinical teams and health systems are well documented.

Remote clinical support and monitoring have the ability to empower individuals to self-manage their condition, reduce emergency hospital admissions and improve outcomes. The economic benefits are clear: better clinical outcomes equal lower costs of care and more resources for reallocation. It is not surprising that many experts have suggested that digitalisation will be key to the future sustainability of health systems.
 

Interoperability is essential

Yet gaps remain between digital aspirations and implementation. For the NHS, several system-level barriers are impeding the move from promising pockets of digital innovation to a fully integrated, digital-first health service. Data would ideally follow the patient across different providers, bridging the gap between private healthcare and the NHS. In reality, information transfer often fails due to a lack of interoperability, meaning vital information is lost or not used. This results in the duplication and/or fragmentation of information, processes and care, leading to a protracted and frustrating experience for patients and clinicians alike.

Health systems lose out too: these combined data could serve as a powerful real-world database. Interrogating this could help identify treatment patterns, measure outcomes of different care approaches, and feed into a continuous cycle of learning and improvement – a learning health system.

 

Appropriate use of digital technologies, including communication to patients about digital approaches, needs to be part of the standard medical curriculum.

 

The importance of public trust

Another important issue is governance. Surveys conducted by the European Commission have shown that most people are happy to share their health data, with the guarantee that information is only shared with those for whom it is intended. Ensuring full transparency of the use of patient data is fundamental, and initiatives such as Data Saves Lives are empowering patients to share their data with the confidence that their personal rights are being protected.

Clinical buy-in is also key: for new technologies to be properly utilised, we need a digitally trained workforce. Appropriate use of digital technologies, including communication to patients about digital approaches, needs to be part of the standard medical curriculum. The cultural shift this represents, for both clinicians and patients, should not be underestimated.

Data solutions need to help clinical practice, not create an additional burden. Data collected must be timely, clinically relevant and actionable for clinicians, supporting shared decision-making and informed consent while avoiding the collection of data for data’s sake. Most importantly, a one-size-fits-all approach to digital health must be avoided, so digitalisation can remedy existing health inequalities rather than exacerbate them.

We are at an exciting juncture on the path to digital healthcare. Collaboration between those developing digital innovations and all actors within the health ecosystem can forge a digitally enabled, person-centred, high-quality future health service, with benefits for all.
 
For more information, read the HPP think piece Digital health in the management of non-communicable diseases in the UK.
 
This blog was written by Matthew Hickey, Chief Executive Officer of The Health Value Alliance, and Suzanne Wait, Managing Director at The Health Policy Partnership.

 

The opinions expressed in this blog are those of the author and do not necessarily represent the views of The Health Policy Partnership.
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