HIMSS and Health 2.0 European Conference Helsinki, Finland 7-9 September 2020
Healthcare has reached a tipping point. Now, using digital technologies, we can finally implement the smart changes that we have been discussing for so many years: redesign healthcare systems around shared goals and patient needs.
Medicine has made significant progress over the last century. Life expectancy is continuously increasing; modern medicines allow for improved patient treatment. Doctors equipped with the most sophisticated tools can help patients with complex diseases. However, this rapid progress has its price. Although we can provide new, efficient services on a vast scale, we have departed from some of the core values: solidarity and fairness, respect for patient’s needs, empathy, and compassion. These are the fundamental values that patients are missing most. How to restore them while healthcare systems are facing increasingly limited financial resources?
The primary source of the problem is that healthcare focuses mainly on treatment (sick-care). Digital health offers solutions that facilitate access to data and knowledge, shifting the focus from hospitals to behavior management. Thanks to data exchanges, wearables, and AI, every person will be able to make health decisions based on best evidence, tailored to the living environment, personal needs, and goals. This reorientation towards individuals wouldn't be possible without new technologies gaining data and translating it into knowledge delivered straight to every participant.
The old, pre-digital model of healthcare has further consequences: the rising volume of services provided by a limited number of doctors. Therefore, highly educated specialists are forced to focus on volume and efficiency, not on quality. Here the circle closes. In the reactive medicine of today, doctors are overloaded because there are no efficient mechanisms to protect patients from preventable diseases. This leads often to frustration and burn-out. There is limited time for empathy, communication, compassion, and human interaction that should accompany medical competences and actions.
The right model of digitalisation, co-created with patients, doctors, nurses, politicians and all stakeholders, could make healthcare more ethical. The most important factor is to integrate the essential principles in the technologies we create, but also to introduce solutions that transform the imperfect way that healthcare is organised today. By following the knowledge provided by health determinants, most people may become sufficiently capable of maintaining healthy lives if guided appropriately. By teaming up with algorithms, doctors could become the designers and engineers of health, and could have more time for patients with diseases that require increased attention.
Digitalisation also helps to remove blind spots from medicine. Disorganised and dispersed information in healthcare corresponds to the Swiss cheese model of accident causation, also called “a cumulative act effect”. There are many layers between a patient’s well-being and disease, between a doctor’s visit and the right treatment. For example, a doctor makes a health assessment, studies the symptoms, measures vital signs, orders laboratory tests, asks about allergies to medicines, and prescribes medication. Every action (layer) exists to guarantee the optimal and safest form of care best suited to treating the disease in question. But in fact, there are so many data holes in these layers. A doctor has no access to the full medical record, doesn’t know the full list of drugs prescribed by other doctors, can’t control the medication adherence of the patient. If the lapses due to the lack of information cumulate, they may threaten patient outcomes or even the patient’s life. Digitalisation connects the missing points in healthcare, integrates data, and covers the data holes, making healthcare more precise and evidence-based. The Swiss cheese model should be taken into account with the same seriousness as it is in aviation.
We are entering the new decade in healthcare with grand visions, and have the right tools to make small improvements that will lead to significant changes for patients. Smart digital health strategies and solutions contribute to a better life for all of us. Tomorrow’s healthcare should make space again for the values that make medicine so special and so deeply human. It is a challenge that requires the joint action of everyone in healthcare. At the HIMSS & Health 2.0 European Conference, there is even a track called just that From Volume to Value, amongst the many exciting tracks. So let’s meet in Helsinki to share experiences, learn from each other and network to build together the future of healthcare.
Digital Health Journalist