Posted by Why is digitalisation in healthcare inevitable? What solutions does it offer? An interview with Dr Charles Alessi, Chief Clinical Officer at HIMSS.
Executive summary
Why is digital transformation inevitable?
- The ageing population and multimorbidity = “overheating health and care”
- Movement from volume to value – moving to population-based capitated systems
- Prevention becomes more critical – and care is being delivered from a variety of places by a variety of people – we need a single version of the truth
- Insights essential – hence the importance of EMRs and agreed taxonomy and analytics – as well as assessing progress via maturity models
What are the opportunities?
- Digital transformation is not merely a transcription of a medical record – it is an opportunity to re-imagine care for people
- Patients have become consumers, and digital transformation makes a more customised and personalised approach possible
- Digital transformation enables the use of Artificial Intelligence to automate and gain insights to improve care
- Precision medicine starts to become possible for the mainstream, not the exception
- Precision health becomes the new personalised, predictive public health
Challenges for physicians (and the reasons for burnout):
- Behaviour modification in non-communicable diseases
- Filling the treatment and administrative gaps
- Managing clinical risks rather than excluding it – which is inherent to success in emerging value-based systems
- Delivering consistent quality care in different geographic locations
- The democratisation of care and managing shared decision making
- Managing the complexity of multimorbidity & patient expectations
- Accurate and consistent contemporaneous record-keeping
Changed nature of the physician/patient relationship:
- Value-based systems drive the management of risk not only its exclusion
- From didactic approaches around giving information to a longitudinal relationship accompanying the person (no longer the patient) in NCDs
- Physician selection and training still mainly 20th century
- Seeing the value of behaviour modification training for physicians and care workers
- Consent – starting to embrace dynamic rather than blanket consent
How will we handle this transition?
- The “ask” around transitioning from the traditional to the 2020 model is enormous
- The development of the primary care home in the traditional model still rudimentary where it is operational
- Governance and process and metrics, let alone financial flows, around the Integrated Practice Units (IPU) still not able to be articulated coherently
- All ageing and multimorbidity and the urgency for other additive solutions increases
- The workforce is ageing at exactly the same rate – although if transition succeeds, potentially requirement may decrease
- Effortless adoption of clinical decision support in mainstream practise is still not widespread
- Delaying the expression of symptomatology from NCDs and in cases development of the disease is the rational next step and can only be achieved via a precision health approach
Precision health is achievable by:
- The use of personal data, appropriately safeguarded, to change the conversation we are having with individuals – business to consumer approach
- Driving personalised engagement at scale, using technology to direct people to advice and interventions that are relevant to individual requirements
- Anticipate and communicate risks in a way that invokes an action, directing people to screening, health checks, social prescribing etc.
- Add a new perspective to population datasets with granular personal information
- Employing real-time feedback and continuous improvement of what works.
What solutions does digitalisation offer?
- Better support of our workforce – from digital immersion classes to phased and sensible EMR deployments where the clinical flow is at least as necessary as “closing the gaps” and ensuring the claim mechanisms remain central
- Clinical decision support – embedded within EMRs to better assist health workers supported by AI to reduce the number of keystrokes + emergence of voice
- Training – in behavioural modification techniques and enabling empowered consultations
- Exploiting digital transformation as a “clinical extender”
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