The unprecedented impacts and consequential social, economic and humanitarian needs introduced or exacerbated by COVID-19 are driving the rapid development and adoption of new digital technologies and at scale. These technologies are also being harnessed to support the public health response worldwide, and the resultant trajectory for digital health solutions has accelerated with greater innovation, investment and mobilization over the past year.
It is a moment of opportunity for transformation; to address systemic weaknesses — insufficiencies and inefficiencies across the spectrum of care, in a way that allows for a sustainable redesign of care delivery.
This pandemic has forced a deeper consideration of healthcare delivery beyond an individual patient focus to a broader lens that looks at implications within and across communities, regions and countries. The development and application of digital solutions needs to emerge from the same lens.
Building the Future of Healthcare
The future state of healthcare needs to be agile and enable flexible and adaptive health practices that can respond to new information or changing trends, continuously improve processes to deliver more value and effectively adopt new technologies to enhance care. Agile health systems will need to involve and interact key system components — infrastructure, workforce and both patient-centric and business-centric digital technologies — that will complement the development of a sensing and responding system.
This means that digital strategies need to be aligned to strengthen pandemic management, but also with a long-term view to building resilient health systems as well as future emergency preparedness.
The key is in patient data, health information and information-sharing. There is a huge potential that digital holds to support epidemiological intelligence, identify cases and cluster infection, rapidly trace contacts, and enable public health messaging at scale. This is critical during a pandemic but can also have transformative impact for public health outside of the pandemic context.
Digital technologies have numerous applications that provide both patient-centric and business-centric solutions, such as preventive and promotive healthcare, patient monitoring and program management, and electronic medical record systems. This is where the following key enablers become very important:
- Data availability and accessibility within a community
- System interoperability to support the development of a coordinated response
- Connectivity to drive agile and rapid information exchange
Accessibility and availability of data pulled from multiple sources is the first step toward achieving an aggregated or holistic view of an individual patient’s health scenario and therefore, a much better understanding of their symptoms and needs. It helps discern trends and patterns within a community. It also means that the most appropriate diagnosis can be made according to a patient's specific health situation. This is especially important for those patients or communities who may be in vulnerable or dire situations. Alongside evidence-based care, quality local data informs sound resource allocation and supports efforts for optimal health outcomes.
Interoperability allows different information technology systems within hospitals and across hospital systems and broader public and private healthcare networks to connect and communicate with one another; to exchange data accurately and consistently; and to use that information effectively. It offers the ability to access and share a patient's clinical information no matter where it is stored or how it is formatted. If aligned effectively, both patients and providers benefit with a safe, secure and seamless access to patient information and vital data.
Connectivity combined with robust interoperability also enables speed within a health system. Connecting various care delivery setups is critical in reaching out to a larger population. This requires a decentralized and flexible approach to expand connectivity. In the context of a pandemic, interoperable EMR systems at every level, for example, would allow access and data sharing across the continuum of care, facilitate better monitoring and reporting of suspected and confirmed cases, treatment regimens and abnormal conditions. This way of exchanging information is agile, permits a quicker understanding of a pandemic’s behavior within a given population and, therefore, enables faster and more comprehensive containment or mitigation interventions.
Analysis and use of these 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 will emerge from collaboration across health ecosystems to address fragmentation. Public-private partnerships and collaborations with civil society and technical communities are growing to enable shared resources and capabilities that will bring the potential for greater social and economic value; industry collaboration is needed to enhance connectivity and interoperability and drive healthcare data integration; development of regulation that keeps up with innovations, or better yet, drives innovation is essential; and greater and stable government investment in digital health can help drive scale.
Building a Digital Foundation
Digital foundations need to be grounded within national digital strategies and the digital determinants of health — digital literacy of healthcare practitioners, the broader health workforce and the population, access to devices, and the quality and coverage of the internet — are essential for the system to tap into the full potential that digital technology solutions offer.
This level of integration serves positively for patients that are able to access health systems, however access to and affordability of quality and coordinated healthcare, particularly in emerging markets, is often fraught with barriers and inequalities. Digital tools and technology have been and will continue to be essential in expanding coverage, enhancing services and reducing cost. So, addressing factors that perpetuate digital exclusion for select demographic groups is critical to ensure the sophistication being introduced in system connectivity, interoperability, and data capture and aggregation can be of benefit to as well as benefit from more inclusive digital strategies.
M. A. Chaudhry, M.D., MBA, is founder and CEO of Emerging Health International, and a nuclear medicine specialist in Baltimore, where he is affiliated with Johns Hopkins Hospital. He is a visionary healthcare executive with successful experience in providing leadership to large integrated health systems, transforming strategic priorities into operational plans and managing change in a complex system.