Health Policy February 18, 2019
The shift to digital healthcare

By Dr Niti Pall - World Healthcare Journal

Navigating the new digital healthcare landscape is challenging for everyone.

The global healthcare landscape is rapidly changing with digital technologies becoming increasingly normalised into the everyday delivery of healthcare. But how does this change how healthcare organisations provide and deliver care?

In the future, the digital landscape might span everything from patients to wider healthcare delivery organisations (SeeFigure1). Patient-facing technologies are at the centre, reflecting the impact that this new ecosystem of self-monitoring and decision support will have on their experience and quality of care. Other technologies are broadly categorised as professional-facing and organisation-facing depending on their primary user and value in enhancing individual patient care or improving care systems. The electronic health record straddles the system as a whole, reflecting the pivotal role it plays in any digital strategy. It is the foundation upon which many of the other applications are built.

Navigating this new landscape is challenging for organisations and their leaders and there are many pitfalls. There is no doubt, however, that technological transformation will be one of the major differentiators between successful and unsuccessful providers over the next decade. The pressures of cost and expectations of quality mean that doing nothing is not a sustainable option.


Deploying information technology in healthcare

The history of health information technology (IT) has certainly not always been smooth. Examples of spiralling costs, slow take-up and elusive productivity gains are found in virtually every health system around the world. Why has healthcare delivery been so resistant to digital transformation, and when big investments have been made, why have strategies so often failed to pay off?

Based on my experience at both local and national levels, perhaps the most important lesson of all is that becoming a digitally enabled healthcare provider isn’t about replacing analogue or paper processes with digital ones. Where implementations have failed, technology has often simply been layered on top of existing structures and work patterns, creating additional workload for healthcare professionals.

For me, the technologies that have released the greatest immediate benefits have been carefully designed to make people’s jobs or the patient’s interaction easier, with considerable investment in both the design of the tool and the redesign of ways of working.

"Technological transformation will be one of the major differentiators between successful and unsuccessful providers over the next decade”

A pattern I’ve seen time and again is the great expectations of new technology clashing against an initial period of frustration and reduced productivity. Benefits eventually materialise — often after two or more years — but weathering this ‘digital dip’ is an important hurdle that has led to many transformation strategies being scaled back or even abandoned.

A case in point is electronic health records (EHRs). These are an essential foundation to any digital strategy, but rarely do they produce any immediate benefits to the frontline. In reality, most organisations see an initial phase of added inefficiencies before the tools that work off the EHR (patient flow management, e-prescribing, automated alerts and data transfer) are developed, implemented and get to work. The unexpected pain of the initial EHR implementation has caused many providers to get stuck in the dip — unable to roll back to previous systems, but unwilling to invest further to get the benefits.


Seven lessons on realising opportunities

I have found that substantial gains in terms of productivity and health outcomes are possible — and have been demonstrated — from specific areas of health IT. As the history of frequent disappointment and failure shows, however, digital technologies will not deliver these improvements on their own. Through my digital transformation experience with healthcare providers around the world, I have identified seven key lessons from those that have successfully realised the benefits and overcome the setbacks.


Seven opportunities to drive improvement

Looking at the highest performing and most digitally enabled healthcare providers around the world, as well as ‘frugally’ innovative organisations in emerging economies, seven improvements in productivity and quality of care stand out.


The way ahead for technology in healthcare – a 10-year view

  • Computing will be much more ubiquitous, but much less visible
  • Much less time will be spent by staff on administrative tasks and routine communication, as automation, voice recognition and natural language processing become more commonplace

  • New roles and competencies will be added to the managerial cadre as the shift to digital healthcare continues — most importantly advanced analytic capabilities

  • Organisational and professional boundaries will be far less visible, as integrated information technology systems dissolve many of the current divides between primary, secondary and tertiary care.


E: niti.pall@kpmg.co.ukT: +44 121 3352733


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