Transforming health systems to achieve sustainable, universal care. That is what was discussed in the two closing keynotes during the first day of the ICT&health World Conference at the MECC (Maastricht). Katarzyna Kolasa, Ph.D., professor of health economics at Kozminski University (Poland), no longer expects a collapse of Western healthcare systems, but she’s also not positive about their development in the coming decades. Madhukar Kumar Bhagat, Ministry of Health and Family Welfare, shows more optimism in achieving universal healthcare with the help of digitalization in a country approaching 1.5 billion residents.
Kolasa warns in her book 'The Digital Transformation of the Healthcare System' about the financial collapse of healthcare systems. She also calls for a fundamental transformation. The increasing use of data, among other things, should help obtain a more holistic view of problems and solutions in the field of healthcare. This growing role of data should trigger a transformational change in healthcare towards an new model: healthcare 5.0.
There are not enough people
“I am not optimistic about the development of the healthcare market,” said Kolasa, who was present online via a large screen. “We spend on average four times as much on healthcare as we did 60 years ago. Many countries are already spending on healthcare what was predicted for 2030. Medical costs are rising for medication, technology, and growing staff shortages cannot be solved with higher salaries, because there are simply nog enough people.”
Digitalization can help here in several areas, the professor expects. “It is not only about offering better treatments, but also using treatments more efficiently. Consider using AI applications that support doctors with faster and sometimes better diagnostics, so that you can give or rule out the right treatment sooner.” But also by better predicting which patients' condition will deteriorate.
Look wider
Furthermore, it is important to look broader than just providing innovative solutions. For example, the American John Hopkins University uses AI applications from aviation to improve triage in its hospital. “By more quickly determining who needs immediate treatment and who can wait a little longer, this alone will save $14 million per year. And what about the health benefit because you can diagnose that someone has had a stroke 80 minutes earlier than normal. You save lives and save costs.”
The speed of innovation, scaling up and applying this holistically in healthcare will have to increase in the coming years, Kolasa believes. “Saving costs and increasing efficiency are two important elements for making healthcare future-proof. But digitalization also helps to give patients more control over their health and treatments. For example, home monitoring often makes a patient feel reassured, knowing that he or she is being watched.”
However, it remains a problem that there is too much focus in healthcare and parties surrounding healthcare – governments, insurers – on treatment. Much more money should be spent on prevention. Now perhaps only 4 percent of the total healthcare budget goes there, while primary and secondary prevention can save enormous costs by preventing diseases – or worsening of conditions.
More focus on behavior
“And prevention above all means more focus on behavior, on predicting and influencing it. Take Singapore as an example. There, the government has introduced apps to encourage all residents to adopt healthy behavior and exercise more, for example food purchasing behavior in a supermarket. This prevents citizens from becoming patients.”
Finally, Kolasa emphasizes that digitalization is not just about technology, but about the will to change on the part of all parties involved in healthcare. Doctors, insurers, governments, but also patients. “And we must realize that the benefits and savings achieved through digital collaboration must also be shared fairly. If you do invest, but the returns end up elsewhere, it is understandable that change is difficult. “Without good and honest cooperation, we can never realize the savings and improvements that are potentially possible.”
Universal healthcare
The challenges in countries like Poland and India are partly the same, but in the latter the proportions are on a completely different level. Digitalization is therefore a must to realize the government's vision of universal healthcare for all in a country of more than 1.4 billion inhabitants, emphasized Madhukar Kumar Bhagat, representative of the Ministry of Health and Family Welfare of India.
Madhukar Kumar Bhagat, representative of the Ministry of Health and Family Welfare of India.
“Visibility and accessibility of care, regardless of where you live, what class, religion or ethnicity you come from, is necessary. But affordability is just as necessary. And all these elements come together in the use of technology and digitalization as pillars.” However, data from all more than 1.4 billion inhabitants forms the foundation. A good picture of the health of every resident is necessary to keep care accessible and affordable. Privacy and security are necessary to give people confidence in the benefits of a universal data system to underpin universal care.
Just like in the Netherlands, India also needs a digital infrastructure that facilitates all forms of data exchange and integration of systems and applications. This is the De Ayushman Bharat Digital Mission (ABDM), which will form the backbone to support the country's integrated digital health infrastructure. It will bridge the existing gap between the various stakeholders of the healthcare ecosystem through digital highways. “There is still a long way to go, but ultimately this infrastructure should make all the necessary data of every Indian available freely and with the appropriate permissions, and thus maintain or improve their health.”
Short of staff
And in India too, despite the size of the population, there is a shortage of medical personnel. This is partly due to the fact that the often expensive private medical schools do not produce enough professionals. And as universal healthcare is achieved, this problem will increase. Digitalization can also offer a solution here.
“Why wouldn't you make teaching materials from private courses available to students in regions with less good courses, for example via live streams or YouTube videos? This way you can make knowledge available to hundreds of thousands of students instead of thousands. This should become possible, especially with the growing penetration of mobile networks. The possibilities are potentially endless.”
