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Healthcare Was Not Built In A Day. Decentralizing It Through Digitalization Will Take Time - ICT&health

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Healthcare Was Not Built In A Day. Decentralizing It Through Digitalization Will Take Time

The ‘big bang’ approach to transformation in healthcare often fails. So how should health care transformation be shaped to build crisis-resilient health systems? In our talk Claudia Pagliari, Director of Global eHealth at the University of Edinburgh, advises: set a goal for technology, buy wisely and train the end-users.

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Organizations should start by optimising their existing capabilities and workflows and ensuring that their information infrastructure is sound, lean and connected and that the processes for collecting, curating and managing their data are sufficiently mature to drive actionable insights.

“Effective use of dashboards and other visualisation tools is one way of achieving the latter, alongside analytical tools for tracking, predicting and modelling risks, events and outcomes. These capabilities are needed at multiple levels – from analysing vital signs in Intensive Care settings to managing patient traffic and staff rostering during a pandemic surge, tracking anticipatory stocks of emergency supplies, or sharing insights from population-based disease surveillance as examples,” according to Pagliari.

Being ready in a crisis also means having the legal and regulatory mechanisms in place to make better use of information when the need arises, as well as the wisdom to know what data harvesting is proportionate and necessary under the circumstances and what to reduce or sunset once threat levels subside. This reflects the importance of maintaining public and patient trust in the use of personal data or potentially identifying data, which also requires broader efforts around engagement and assurance.

How to realise the full potential of technology

“First, be clear on what technology is needed for what purpose and with what likely outcomes. Second, prioritise careful and strategic procurement over knee-jerk spending and invest in activities that make the best use of existing products and workflows when these are fit for purpose. Third, ensure that staff is in a position to utilise available technology and information,” suggests Pagliari during her keynote at the EIT Health Summit 2022.

“For example, having an Electronic Patient Record (EPR) offers little benefit if staff have no time to use it during patient handover. Consider making better use of alternative modes such as mobiles and wearables.”

Changes in healthcare expected due to the COVID-19 pandemic

Having successfully delivered remote care and hybrid working during the crisis, many health organisations and policymakers are keen to maintain these for routine care.

“High pressures on public healthcare systems during the pandemic have also seen a proliferation of private-sector providers, some primarily working via digital platforms, as well as the growing use of patient self-help tools,” says Pagliari. The Director of Global eHealth at the University of Edinburgh believes this reflects a cultural, philosophical and economic shift towards flexible and decentralised healthcare. “On the other hand, however, the extent to which these services will persist in the longer term remains to be seen.”

Digital-hybrid care delivery is on the rise. But are they beneficial for patients?

“The greatest success has been in maintaining health service delivery, despite physical restrictions and a health workforce crisis. In terms of patient outcomes, however, the evidence is still unclear. This is partly because many changes were introduced at such speed that evaluation wasn’t factored in,” remarks Pagliari.

The benefits of digitisation may have even been masked by the overall negative impact of the pandemic on healthcare access and outcomes. On the other hand, emerging evidence suggests a failure to achieve benefits from video consulting, with normal telephones being equally effective and often more acceptable in primary care settings.

“The value of having robust and up-to-date electronic patient records in such circumstances is self-evident and this capability has differentiated strongly from weak health systems worldwide,” concludes Pagliari.

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Professor Claudia Pagliari

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