7 February 2018

‘A dramatic shift’ – but in which direction?

KnowCents Technology

Late last year, a new report from The Harvard Business Review Analytical Services, covered in these pages, added to the cacophony of calls for a “dramatic shift” in thinking on digital healthcare.

The report includes the results of 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.

Much of the reaction to the study has focused on patient-centric solutions. This involves opening up siloed data and giving patients control of their own data.

There is no doubt this has merit. The current situation, where data falls between the cracks of a fragmented system and inefficient care cycle, and where pools of data are held in isolation, helps no-one.

To drive healthcare improvements we need to enable the flexibility and ease of service which is commonplace in other industries, and give patients access and control of their own data.

That said, focusing purely on the patient poses a risk to the effective use of data in healthcare, and could lead to poorer outcomes. Instead, we must ensure data democratisation is patient-centric, but practitioner-aligned; empowering practitioners with patient information to better inform their care.

Context and education

If a practitioner doesn’t understand the context of data, they won’t know how to use it properly, and that can lead to bad decisions.

The incorrect application of data can cause misdiagnosis or incorrect prescriptions being issued, but more than that, it can erode trust between the patient and the practitioner, damaging long-term health outcomes.

In addition to context, there is also a need for education. Ensuring practitioners have the skills, time, and job structure to access, filter, visualise, and apply vast swathes of data, is vital to its successful use. Only then will practitioners – and by extension patients – truly benefit from data democratisation.

Finding the right incentives

The debate around how to best use data is a constant issue in the healthcare sector, but recently rose to the top of the agenda with the decision to replace current practice incentive payments with quality incentive payments. This controversial move will see data used to monitor how practitioners are making a difference, then pay them accordingly.

Using financial incentives as a lever to improve performance is an age-old method of bringing about behavioural change. Despite the good intentions underpinning these policies, they often cause unintended consequences, with the wrong behaviours being incentivised.

Instead, data should be used to benchmark performance, establish best practice, and judge performance over pay. By using aggregated data, we’re able to improve patient outcomes and allow practitioners to calibrate their performance.

We can identify trends among practices, communities, or cities and states, to identify and drive areas of improvement – not to use it in a way that is punitive or for the purposes of policing, which is a temptation for funders and regulators.

Making data work for healthcare

As the Harvard Business Review report pointed out, a dramatic shift in thinking around digital health is vital to the continued success of our healthcare system.

The current system is outdated, resulting in a convoluted and disjointed experience for the patient, and is an afterthought when it comes to the delivery of care.

However, if the dramatic shift moves the system too far the other way, and fails to take into account the practitioners who remain integral to successful health outcomes, it will only change the system, rather than improve it.

A modern healthcare system needs to not only be patient-centric, but practitioner-aligned.

Our use of data should follow the same model, being designed to work for the improvement of the healthcare system, across both patients and practitioners, rather than wielded to tilt the system too far one way, or to attempt to create incentives focused around financial reward.

Other industries have been well and truly disrupted by data, and have had to navigate an occasionally bumpy road along the way. With healthcare, those potential bumps can have consequences no less serious than life and death.

The industry needs change, but it needs to be done carefully, and from the inside.

Data must work for healthcare, and not the other way around.

Dr Marcus Tan is CEO and Medical Director of online health appointment service HealthEngine