The unprecedented impact and resulting social, economic and humanitarian needs introduced or exacerbated by COVID-19 are driving the rapid development and adoption of new digital technologies and on a large scale. These technologies are also being used to support the public health response worldwide and the resulting pathway for digital health solutions has accelerated over the past year with more innovation, investment and mobilization.
It is a moment of opportunity for transformation; Addressing systemic weaknesses – inadequacies and inefficiencies across the spectrum of care – in a way that enables care to be redesigned in a sustainable manner.
This pandemic has forced a closer look at health care beyond the individual patient focus to a broader perspective that looks at the implications within and between communities, regions and countries. The development and application of digital solutions must arise from the same perspective.
Shaping the future of healthcare
The future state of health care must be agile and enable flexible and adaptable health practices that can respond to new information or changing trends, continuously improve processes to create more value, and effectively use new technologies to improve care. Agile healthcare systems need to incorporate and interact with key system components – infrastructure, workforce, and both patient-centric and business-centric digital technologies – that complement the development of a sensor and response system.
This means that digital strategies to strengthen pandemic management, but also with a long-term perspective, must be geared towards building resilient health systems and future emergency preparedness.
The key lies in patient records, health information and information sharing. The digital potential has tremendous potential to support epidemiological intelligence, identify cases and cluster infections, quickly track contacts, and enable large-scale public health news. This is critical during a pandemic, but it can also have transformative public health effects outside of the pandemic context.
Digital technologies have numerous applications that provide both patient-centric and business-centric solutions, such as preventive and promotional health care, patient monitoring and program management, and electronic health record systems. The following key enablers become very important here:
- Data availability and accessibility within a community
- System interoperability to aid in the development of a coordinated response
- Connectivity for an agile and fast exchange of information
The accessibility and availability of data from multiple sources is the first step to an aggregated or holistic view of the health scenario of an individual patient and thus to a much better understanding of his symptoms and needs. It helps to identify trends and patterns within a community. It also means that the most appropriate diagnosis can be made according to the patient’s specific health situation. This is especially important for patients or communities who may find themselves in vulnerable or dire situations. In addition to evidence-based care, high-quality local data informs about sound resource allocation and supports efforts to achieve optimal health outcomes.
Interoperability enables different information technology systems within hospitals and across hospital systems and broader public and private health networks to connect and communicate with one another; to exchange data accurately and consistently; and use that information effectively. It provides the ability to access and share a patient’s clinical information regardless of where it is stored or how it is formatted. With effective coordination, both patients and providers benefit from secure and seamless access to patient information and vital data.
Connectivity combined with robust interoperability also enables speed within a healthcare system. Connecting different care facilities is critical to reaching a larger population. This requires a decentralized and flexible approach to expanding connectivity. For example, in the context of a pandemic, interoperable EMR systems at all levels would enable access and sharing of data across the care continuum, facilitate better monitoring and reporting of suspected and confirmed cases, treatment regimens and abnormal conditions. This type of information exchange is agile, allows for a faster understanding of the behavior of a pandemic within a given population and therefore enables faster and more comprehensive containment or mitigation interventions.
The analysis and use of this data will depend on the digital infrastructure and readiness of health systems, including an enabling legal and regulatory environment, information governance, incentives to prioritize interoperability, data protection and cybersecurity. Optimal benefits result from working together across health ecosystems to counteract fragmentation. Public-private partnerships and collaborations with civil society and technical communities are increasing to enable shared resources and skills that bring the potential for greater social and economic value; collaboration with industry is needed to improve connectivity and interoperability and drive integration of health data; It is essential to develop regulation that keeps pace with innovation, or better yet, drives innovation; and larger and more stable government investments in digital health can help drive scale.
Building a digital foundation
The digital foundations must be anchored in national digital strategies, and the digital health determinants – digital literacy of health workers, the broader health workers and the population, access to devices, and the quality and coverage of the internet – are essential for the system to achieve its full potential exploit digital technology solutions.
This level of integration benefits patients who have access to health systems, but the access to and affordability of quality and coordinated health care, especially in emerging economies, is often fraught with barriers and inequalities. Digital tools and technologies have been and are vital to expanding coverage, improving services and reducing costs. Therefore, it is critical to address factors that perpetuate digital exclusion for select demographics to ensure that the sophistication introduced into system connectivity, interoperability, and data collection and aggregation can be useful to both more inclusive digital strategies.
MA Chaudhry, MD, MBA, is the founder and CEO of Emerging Health International and a nuclear medicine specialist based in Baltimore, where he is affiliated with Johns Hopkins Hospital. He is a visionary healthcare leader with successful experience leading large integrated healthcare systems, transforming strategic priorities into operational plans, and managing change in a complex system.
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