6 November 2017

How data democracy will reshape healthcare

Communication MyHealthRecord Technology

Australia will need to make “a dramatic shift” in thinking on digital health to maintain its world-leading quality of healthcare, according to a new report from Harvard Business Review (HBR) Analytic Services.  

The HBR briefing paper, sponsored by Microsoft, stemmed from an international survey of 783 business decision makers on digital transformation, including 9% employed in the health sector, as well as qualitative interviews with Australian digital health experts.  

In Australia, an unsustainable spending trajectory, the rise of digitally literate consumers, the burden of chronic disease and demographic factors made the take-up digital technologies a crucial need, it said. 

Dr Chris Pearce, a GP and president of the Australasian College of Health Informatics, said the embrace of digital health was just beginning in Australia.  

“We are on the verge of the most significant shift in how we deliver healthcare since the scientific method arrived,” he said. “People’s records can’t be locked up anymore. Those who adapt will gain work, and those who don’t, won’t.”  

The technological empowerment of patients was potentially the biggest disruptor of all, he said. 

“Doctors used to be the fount of all knowledge, and people had no means of questioning it.  

“The biggest disruptive pressure on the healthcare system is the democratisation of data and the inexorable move to true patient-centred care.” 

Professor Johanna Westbrook, director of the Centre for Health Systems and Safety Research (CHSSR) at Macquarie University, is quoted as saying that the ability to track patients electronically would be essential.  

“We need to use records to follow people beyond one consultation to see improvement over time,” she said. 

The disappearance of the “GP for 30 years” care delivery made EMRs a key part of the challenge, the report said.  

The two areas of digital technology vital for the looming changes in healthcare delivery were the cloud and artificial intelligence-driven analytics, it said.  

While cloud services were central to leveraging the burgeoning volumes of patient data that healthcare organisations must collect, the sheer size of these valuable data stores posed a data management challenge.   

Internationally, the growth had been estimated at 48% per year, driven by electronic health records and medical imaging, it said.  

“We need to deliver care; reduce errors, waste, and duplication of services; and create a sustainable system amid growing expectations and financial constraints,” Professor Westbrook said. 

Realising these goals would require a “dramatic mindset shift for a sector that has been reliant on largely paper-based processes, and in which data on patient care, treatment costs, and health outcomes has been fragmented and not easily accessed”, the briefing paper said.  

Internationally, digital transformation in healthcare was being driven mostly by the desire to create a better experience for patients.  

“An exceptional, highly relevant patient experience” was the leading priority, cited by 48% of the digital healthcare respondents in the HBR survey. 

Next came “enhance our operations for intelligence and speed” (25%), followed by “transform our existing product or business models to be more information-based” (16%). 

Despite the efforts of progressive organisations in Australian healthcare on electronic medical records, e-medication programs and patient engagement platforms, significant efforts would be needed in cultural change and other areas, the paper said.  

Richard Royle, national digital health leaders at PricewaterhouseCoopers Australia, said the entire digital agenda for healthcare organisations would needed to be driven by consumers as they gathered more personal information through devices and desired a better understanding of their health. 

“The healthcare industry is hugely conservative, with clinicians historically thinking the information they have is their own,” he said. “Particularly with growing out-of-pocket costs, patients want to understand the value equation for their health expenditures.” 

Mr Royle, who was acting CEO of the Australian Digital Health Agency on its start-up, said PwC research showed ehealth records had significant benefits in hospitals, leading to an improved length of stay, operating theatre throughput, and clinical outcomes. 

“The ability to document, in an electronic record, the clinical pathways to follow for diagnoses produces greater consistencies of clinical outcomes and reduces readmissions.”

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