While there are many current challenges in healthcare, there are also a multitude of opportunities. On the one hand, there are constant challenges and barriers that the health system presents as a fragmented service and the difficulties of connecting care. On the other, there is so much more data and so much more digital capability to leverage and to share what works, allowing us to learn from others who are actively moving the agenda forward. The health crisis of the pandemic has highlighted the importance of digital technology in healthcare.
There are immediate ways we can move forward, with a greater consumer and health practitioner focus, to advocate and progress system change. In 2021 the Clinical Engagement and Digital Health Thought Leadership Series, a collaboration between the Australasian Institute of Digital Health (AIDH) and Cerner, deduced eight key insights with real time practical applications.
Timing is everything – never waste a crisis
The COVID-19 pandemic has highlighted the need for change to many across the healthcare ecosystem, both because of the constraints it has placed on the delivery of care and traditional models of paper records, but also because of the unique demands on healthcare workers, institutions, and consumers. Across all three events, we were highly encouraged by the breadth of the changes, experiments, research, and interventions underway to better leverage digital health to support these changes. Participants across the system are diving in and using longstanding technology capability in new and innovative ways to help the healthcare system adapt. From telehealth for chronic care, to leveraging consumer apps, to new models of clinical data exchange across hospitals and into the MyHR, there is new energy and traction for change.
Share what works
Our healthcare system is full of silos. Some are driven by our national federation whilst others are the result of institutions, clinical care modalities, technology, and data silos – or even individual clinician practices. In a broader systemic context, some silos are the outcome of the separation of healthcare from its social context and approaches to socio-economic issues, disability, and elder care. Great work is underway, so the continuing challenge is to share what works widely and to promote the adoption of the changes, tools and practices that are driving new value. We can all benefit from looking at the lessons learned beyond our own silos.
Goals and principles matter
In each of the sessions, it became clear that jargon is not a great guide to action. The topics themselves are loose and can be widely applied. Having clarity around the goals of each project and key principles that shape the work is a way to narrow the jargon to meaningful action and to unite a diverse range of stakeholders in work that matters. Patient engagement that is merely a check-box exercise destroy value, as do data dumps without integrity or the right context. Value-based healthcare can be meaningless or counterproductive unless value is made clear to all involved.
Consider the consumer, their goals, and experiences
The healthcare system is working hard across the landscape to better understand the consumer, their goals and their experiences. In this work, the industry is discovering that consumer perceptions of value and consumer expectations are shaped by digital experiences and standards well beyond the healthcare landscape. Consumers are considering how the health ecosystem supports their ability to communicate effectively, and make sound and informed choices, as well as enjoy transparency and speed of response. Not all of these demands fit with the healthcare system today, but they highlight the need for dialogue between healthcare providers, the broader system and consumers to better understand value, outcomes and what is reasonable. Importantly, the consumer experience begins long before a healthcare intervention and continues long after. Taking this perspective can help us unravel new and better interventions across the system and to see across narrower silos for better measures of value.
One size does not fit all
Unsurprisingly, people differ in their needs and their preferences. We cannot expect to impose one technology solution on every persona, scenario, or moment. The challenge is to offer choices and options that balance the need for breadth and depth as well as support consumers’ varying routines and the clinician’s need for integration into workflow. Smart interoperability can help, but we must also recognise that just as there is a profusion of apps of similar purposes beyond healthcare, the same may be required in this system to meet the breadth of needs.
Plan for hygiene factors
In all the work we do in systemic change in healthcare – and especially in digital health – a range of common hygiene factors repeat through discussions. Consultation with participants in the system from consumers to administrators and practitioners must be real and broad enough to ensure that the right problems are tackled with the right measures of success. We must support privacy, choice, and control for consumers. Importantly, we must also make sure our digital technology solutions are supported by quality data and integration to workflow. We need to work with practitioners to manage change and gather evidence that can help propagate the effective changes further.
Priorities matter
We cannot do everything at once. Each participant, each institution, and the managers of the healthcare system as a whole need to set priorities and roadmaps. Transparency of this work can help others to learn, as well as provide their inputs in what matters next. The system will be driven by a vast array of increasingly agile iterations, but we can do much to guide this work and select our investments with priorities and roadmaps.
Technology is already available
Although there is a perception in the health IT community that certain tools and systems are not yet available, much of the required technology is in fact already developed and ready for use. Tools such as FHIR, health information sharing platforms, population health management solutions and big data analytics are readily available in the market today. However, they are currently underutilised. We need to develop an accurate industry understanding of what is available and ready for use and ensure that we take best advantage of such resources.
There is much to do in realising the potential of digital technology in healthcare to the benefit of the wider system transformation. The insights paper highlights the breadth of powerful work underway, and the broader questions of choice and control in healthcare, disability, and aged care.