Reinventing healthcare in a post-COVID world

There is no doubt the COVID-19 pandemic has caused the most significant disruption to healthcare, at a global level, we have ever seen. Health systems across the world have been forced to rapidly respond to what has shown to be a formidable threat to human life and to our systems of care.

In Australia, our public health experts, clinicians, healthcare administrators and everyone who supports them, responded so quickly, at such an unprecedent scale that we are faring far better than many other countries.

Philosophers and indeed, health and wellness gurus, encourage us to live in the present; as generally humans struggle with this concept as our brains and busy lives gravitate to thinking about what’s next – this afternoon, tomorrow, next week; and don’t find as much time as we should to reflect on what has come before.

And then, we find ourselves living through a global pandemic – mourning for the past, uncertain for the future and struggling with the uncertainty of normalcy.

But with such uncertainty comes opportunities for reinvention. At the present time, history is not something we will simply reflect on, but we are living it and, better still, we are creating it.

As leaders in the health sector, we have an unparalleled opportunity to ensure that we leverage the learnings of the current time to lead transformational change across the health sector.

A truth of the pandemic is that it has led to a massive increase in the use of telehealth and virtual care. However, now is the time for us to create a new truth for health that goes wider than telehealth and virtual care. A truth that is centred on a transformational shift in the way we view and practice healthcare. A truth that squarely places emphasis on patient centred care and which acknowledges and leverages the innovation that our health sector has proven it can do.

Does your lived experience resonate with the saying that “everyone wants to be innovative, but no one likes change”?

Wicked problems

Health is full of wicked problems that urgently need solving and all too often the nature of the complexity overwhelms change efforts. However, I’ve never met a single person in our sector that questions why they are here or why they do what they do.

In health, we have a major advantage when it comes to change and that’s you and your clear understanding about why you do what you do.

It is this motivation that binds all of us – we are here to impact the lives of individuals and the lives of populations through improved health outcomes. Whether you are a clinician, a specialist in health informatics and digital health, an engineer, a health information manager, a ward clerk, an executive, whether you are literally on the frontlines of healthcare or whether you work behind the scenes to support those on the frontlines – we all have role to play.

We have a lot of work to do and change is never easy. But it’s a lot easier when we work as a collective on addressing a problem that needs to be solved.

Responding so rapidly, at scale and collaboratively to the pandemic has proven beyond a doubt how the health sector will innovate and embrace change when the reason to do so is clear. With apologies to Richard Thaler, forget a polite nudge – if we believe that health outcomes will improve as a result, then we’re all in for change and more than that, we will blow you away with just how transformational we can be. If they gave out medals for innovation, the health sector undoubtedly gets the gold!

So, where to next?

The majority seem to agree that we do not see a future state where health slides back to ‘pre-COVID’ days. And if that is the case, then we have a unique opportunity, maybe even a once in a lifetime opportunity, to reinvent ourselves. The reinvention won’t happen overnight, but it has already begun.

The pandemic has shone a light on clinical innovation, but it has also shone a very bright light on a range of issues including:

• Data: The spotlight is firmly on healthcare data living in silos and the inability of health data to easily move around the system (with appropriate privacy and security protocols of course) and be valuable to clinicians, and to consumers themselves.

  Of course it has also proven there is a gaping wound in the sector’s ability to capture data for epidemiological and public health purposes. And then of course there’s the struggle to manage the data and analyse it in a timely fashion for it to be valuable. COVID has made a good case for real time data capture and analysis.

• Consumers: Consumers have had their awareness raised overnight in knowing that telehealth is an option.

  For too long, healthcare consumers have been largely denied access to virtual care. But there is work to do in addressing affordability issues, enhancing health and digital literacy, and to ensure that consumers don’t feel that telehealth is somehow a ‘less than’ option. Maybe we can borrow from the success of the by-line of Channel 10’s The Project and say “Telehealth it’s Health, delivered differently.”

• Telehealth: Telehealth is not new. But what IS new is telehealth at scale. When it comes to virtual care though, we have a long way to go. Gone are the days, I hope, of telehealth having “more pilots than Qantas”. But there is still much research that must be done on how best to use telehealth as virtual care. We need to understand what has happened with virtual-first healthcare and ensure that the promise of virtual care is realised. Where it assists in the delivery of patient centred care, improves equity and accessibility to care and doesn’t detract from these goals.

  We also have work to do on standards supporting the advancement of telehealth technologies. Health professionals and consumers deserve to have access to technology that they can trust and that meets standards in a range of issues such as interoperability, security and user experience.

• Workforce: Simon Sinek, of TED Talk fame said: “Working hard for something we don’t care about is called stress: Working hard for something we love is called passion.” But for many health professionals these last few months, their experience has been one where these states collide.
  • We need rapid action to make technology and data flows to integrate into workflows more easily. We must avoid the ‘digital burnout’ conundrum facing our US colleagues and do more to ensure that digital is done safely and gets information into the hands of clinicians where it is needed, without unnecessary bureaucracy.
  • We must understand that building workforce capability in digital health goes way beyond teaching someone how to work a particular piece of software or hardware and that all clinicians require some level of digital health competence.

  At the Institute, we have prioritised supporting the workforce in their readiness for digital health and in growing the profession of experts in health informatics and digital health.

  To date the CHIA certification program has certified more people in informatics than any other equivalent program in other countries. We have recently worked with the Australian Digital Health Agency and Australia’s nursing and midwifery bodies to create the first national digital health capability framework for nurses and midwives.

For the benefit of all our citizens, we can and must do a lot better to support clinicians as our health system becomes increasingly digital.