Sunday, November 22, 2020

Administering Digital Health - Challenges of healthcare post Covid..

Healthcare professionals the world over during this Covid time are getting engaged with their patients through the Internet, the process is commonly called Telehealth. We see healthcare professionals interacting with patients and the public through different communication means, Whatsapp, ZOOM calls etc. 

Adaption of digital technologies in the healthcare sector is majorly observed in areas such as 

  • customer engagement - engaging with patients
  • care coordination - delivering personalised patient care
  • improvements in remote work capabilities - distance is not an issue as I can get checked by doctors from Harvard Medical school or from from my nearest Public Health Centre
  • expansion of the use of telemedicine - doctors checking patients using digital tools and prescribing medicines and procedures, even going to the extent of carrying out medical / surgical procedures over the Internet

Lisa and Lawrencein their HBR paper of November '20 "The pitfalls of telehealth and how to avoid them" (click here) points out the main issues in the field of telehealth globally. Healthcare issues all over the world during this Covid time have been very challenging. These are mainly related to access, while the rich are able to access the best doctors, disparities in access exist for vulnerable population, racial and ethnic divisions, elderly, low income and less educated groups in both the developed, developing and less developed countries of the world.

The medical professionals are also facing great challenges both in terms of 

  • video fatigue, 
  • longer work days 
  • erosion of work life boundaries resulting in burnout and 
  • work life disruption. 
Proper exercise of telemedicine results in good telehealth. Telehealth is very popular and very effective these days except for the above problems. People above the age of 65 years, black and hispanic patients, (like the tribals and backward classes in India) are less likely to use telehealth as their Internet access is also limited. 

In all probability, post Covid, the digital health systems we have been exposed to presently will stay and be part of our daily interactions. Our medical experience is going to be of a hybrid nature. It will be observed in the following four areas.

  1. Better customer engagement
  2. Care coordination
  3. Improvement in remote work capabilities and
  4. Expansion in the use of telemedicine

Some of the most popular applications of digital interventions in the Healthcare sector as highlighted in the HBR September 2020 paper titled 4 steps to digitize healthcare for the long term, by Siemens Healthineers (click here) are 

  • electronic intensive care units (eICUs), 
  • home monitoring of patients, 
  • virtual forward triage, 
  • remote care 
  • digital communication.

Siemens outlines four steps to have a smooth digital health transition. 

  1. manage data as a strategic asset, both clinical and operational data need to be separated with proper security protocols applied
  2. empower data-driven decisions deploying AI tools to make sense of patient data and operational data to help take the right decisions
  3. connect care teams and patients including home monitoring with secure tele-consulting
  4. build a learning health system with aligned incentives, learning from past experiences, with a commitment to digital transformation

The article by Lisa and Lawrence mentioned above, "The pitfalls of telehealth and how to avoid them, in HBR, November 2020, mentions the challenges experienced by healthcare professionals and patients.

1. Different telehealth systems in different countries and different hospitals in the same country, both in private and public sector raises issues of inter-operability, which needs to be addressed and reduced. Standardisation of processes, procedures, equipments can help a lot in this regard.

2. Provide all means to improve the communications between healthcare providers, professionals and patients, better communication can remove all non-standardisation problems

3. enhancing the relationships between the providers, doctors and the patients, by way of frequent meetings, sharing of knowledge

4. improving the quality and efficiency of healthcare by having hygienic tools, reliable equipments, machines and qualified and experienced healthcare professionals

Healthcare systems post Covid will see a great change with more telehealth opportunities appearing across the horizon, which is here to stay.

Can we depend on digital health tools to help us in this initiative ? Shirley and Mitesh in their article in HBR Nov '20, "Digital health tools offer new opportunities for personalised care", (click here) give us lot of ideas on this. The biggest change going to happen is in the area of personalised medical care that can be given to the patient in his or her home. 

In the study reported in the above article, digital health initiatives administered on a control group and three other groups with different personal health initiatives helped reiterate the fact that just like in service industries, we tend to deliver personalised experiences to the customer, in the same way, we need to be personal with each patient in administering digital health initiatives. We need to understand what suits each customer, according to their physical activity status and deliver them personal digital health initiatives.

George..

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