Those of us working in healthcare for many years have known the opportunities, benefits, and challenges of connecting care through digital health – whether using interconnected systems across providers, better use of telehealth and virtual care, leveraging mobile technologies and consumer apps, or applying data analytics.
A webinar on the application of digital health and the progress of driving to a nirvana of connected care this week heard from a panel of health tech and aged care leaders who were told: “Aged care is an edge case for health: It acts as the canary in the coal mine for broader aspects of skillsets and connected care.”
The webinar heard the report from the Royal Commission into Aged Care highlighted several key gaps in service delivery and connecting care which are mirrored across healthcare generally. We have made a lot of progress in applying digital health across healthcare. However, we still have some way to go, as the Royal Commission report highlighted.
George Morris, Global Healthcare CIO, Dell Technologies, provided industry and sector trends on healthcare accelerating its application of digital capabilities and moves to reduce silos and greater collaboration. This is particularly evident in virtual care and chronic disease management scenarios where there is a critical requirement to address delivery of care under the pandemic conditions. There are now examples where there are health services delivering these new types of connected services at scale internationally which we can learn from. George Morris said: “On international trends – the global pandemic has seen new core digital capabilities accelerated and a significant shift in healthcare to reduce silos and increase collaboration.”
To implement digital health change into large aged and home care service delivery we need to understand the challenges for people, process, and workflow in connecting care. This is particularly important as we move more and more to home care as a preferred model of care. Siegi Schmidmaier, Executive Director SA, Strategic Developments and Partnerships, Silver Chain Group, provided practical examples where digital health is already being applied to home-based care in supporting patient monitoring and progress. This included the application of digital imaging for wound management scenarios with supporting diagnostics and algorithms which makes these solutions easy to use and applied to current care models. Where there are challenges is where we need to implement larger change in moving to new business and delivery of care models. We need to address the risks involved and ideally apply the learning from others who have already made the change. Siegi said “In aged and home care settings we need to make solutions and workflow easy to understand and simple to use if we are to reduce risk and get uptake.”
To address change management, we need to be able to provide the evidence to support these moves. The recent Royal Commission Report provided many examples and evidence of where care provision and delivery of services can improve. Dr George Margelis, Independent Chair, Aged Care Industry Information Technology Council (ACIITC) stated that digital health capability is becoming increasingly and readily available with a multitude of solutions. The case is really about investment and change in our service and care delivery models. We need investment cycles that support these changes i.e., moves towards home-based care, but supported by evidence to enable those decisions. This is not new to us, but just as relevant. What are the metrics we need to capture (e.g., improving quality of life) and are we capturing them? George left us with a message that: “To enable change management so as to ensure adoption, it is all about the evidence. Are we capturing all the metrics we need to enable decision making and change”
Translating digital health innovations and technologies into broader use and adoption in clinical settings is all about the evidence base. Dr Isobel Frean, Senior Consultant, Digital Health CRC, supported the discussion, saying we need the evidence on quality and safety aspects on any clinical solution. However, on broader adoption we need to have evidence on the quantitative measures on efficiency. Cost and efficiency for larger health service providers is still a compelling driver for change. To address this reality, we need to encourage and support innovation to move to new business models, partnerships, and translation of digital health capability. She said that “Once we have clinical aspects of quality and safety tested in any digital solution, the question then is around what is the quantitative evidence on efficiency.”
Whilst digital system interoperability is still a work in progress for health and aged care, there is evidence of progress on a number of fronts. Steven Lazer, Global Healthcare CTO, Dell Technologies, advised that there are many advances in digital devices and interoperability, particularly around wave form capabilities, compatibilities on image, audio and video files which are making it easier and easier to integrate. He says Dell Technologies is currently compiling a market study on integration of health technologies and devices internationally which would be available later in the year. However, the panel agreed that we have a long way to go with interoperability in Australia and any best practice examples and lessons to be learned would be welcomed. George Morris, Dell Technologies, added: “Interoperability of systems and devices is still challenging and important. But it is important to keep it simple.”
The discussion also centred around change management. We understand the challenges of change in healthcare and clinical service delivery. As the aged care sector looks to respond to connected care issues highlighted in the recent Royal Commission, it is important to have a “people, process, and technologies” approach to change. Health and aged care service providers need to either enhance existing or drive new business models as we move more to home-based care and digitally supported services. George Morris, Dell Technologies commented that where we have seen success in large organisations, there is a case for change built from the ground up, to get consensus and buy-in. This will be particularly relevant as some organisations in the sector reimagine themselves. He said: “Change management is one key area that has got to be built into the organisation’s initiatives from the ground up to have success.”
The webinar was hosted by the Australasian Institute of Digital Health (AIDH) and Aged Care Industry Information Technology Council (ACIITC) and facilitated by AIDH Fellow A/Prof Paul Cooper Deakin University. We acknowledge and thank the sponsorship of Dell Technologies and Intel and their participation and industry insights. A copy of the webinar can be found here on Digital Health TV.