Can digital save health?

Healthcare touches the life of every citizen and for that very reason we share a common interest in accessing the best possible services for ourselves and our loved ones. However, healthcare systems represent a complex network of stakeholders including patients, healthcare providers, insurers, government agencies and the pharmaceutical and MedTech industry, all of which have a myriad of complimentary and sometimes competing priorities.

Despite Ireland’s achievement in having the fourth lowest mortality rate of OECD countries during the Covid-19 pandemic, today we face sustained pressure on our healthcare system. But Ireland is not unique in this regard, many countries are facing unprecedented demands for health services combined with workforce shortages, year-on-year cost increases and the need to meet the expectations of a more informed and engaged public. As we look forward to living longer and enjoying the benefits of scientific innovation, governments walk a tightrope of balancing the needs of the population with the capacity of an increasingly complex healthcare system.

The Minister for Health, Stephen Donnelly recently launched the Government’s strategy for digital health, ‘Digital for Care: A Digital Health Framework for Ireland 2024-2030′. The strategy outlines a practical approach to anchor investment in tangible benefits for patients, providers, and broader society. It provides Ireland with an opportunity to transform our healthcare system while acknowledging the reality that we cannot reasonably expect to deliver high-tech care in a low-tech environment. In truth, our trac record of investment in this domain has been sporadic over the years. While innovative technologies have reshaped entire sectors, we generally see healthcare technology as an ‘accessory’ to existing care models rather than an opportunity to reinvent the way healthcare is planned, delivered and experienced. Inherent to realising the potential of truly transformative technologies is a whole-of-system reimagining of healthcare service provision, backed by long-term commitment and accompanying multi-year investment.

Are we reasonable and fair in our expectation of the system? Patients surely have a justifiable expectation to access the right care, at the right time in a setting that provides the best opportunity for a successful health outcome. Yet, access to services remains the greatest global challenge in healthcare. As a society, we have become accustomed to, and have generally embraced, the convenience digital disruption has brought with it. While disparities still exist, patients are increasingly technologically literate, and keen to equip themselves with the knowledge to actively participate in managing their health and wellbeing. Patients see themselves as consumers of health services, rather than passive participants or recipients of generic information. With this consumerisation of healthcare comes the expectation that services are delivered in an integrated and easily accessible way. Achieving this level of flexibility for both patient and caregiver is impossible without technology.

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Automation, virtual health and generative AI are just some of the innovations transforming healthcare. Just as the world has become accustomed to virtual consultations over recent years, emerging technologies are increasingly considered as a first port of call for routine illnesses. Busy GPs will be assisted by virtual visits, home testing and electronic prescribing. Secure data platforms, ‘real time’ information, mobile apps and an integrated web of healthcare providers will facilitate consultation, diagnosis, prescription and delivery to your door. The benefits are many, enabling patients to manage minor illnesses at home, while increasing the capacity for our hospitals and healthcare professionals to dedicate their expertise to those with the most complex needs.

Digitisation of health care records can be viewed as a first-step in revolutionising healthcare delivery, and its benefits around time saving for staff together with improved patient experience are well documented. Integrated care is a core tenet of Sláintecare, and connected care is predicated on the ability to understand an individual’s healthcare journey. This view can be provided through electronic health records (EHR), available to the patient and providers across the health ecosystem. While Ireland currently has a relatively small EHR footprint, the potential to expand the use of EHR’s is now emerging and bringing with it the benefits of ‘real time’ information to assist with population health management and preventative care. Core functionalities such as electronic prescribing, ordering and digitised clinical documentation can help address a multitude of daily struggles for healthcare workers, and in turn support the delivery of a more coordinated care pathways for patients. EHRs support the use of mobile applications, enabling appointment management and medication management. Like most technologies, traditional EHR’s are continually being refined with fully customisable cloud-native AI-enabled EHR’s pushing the boundaries.

Clinicians are benefitting from emerging technologies such as advanced analytics, ambient intelligence and generative AI, particularly in the domains of early disease detection, supporting clinical decision-making, diagnostics, and case management. With 100% of the population having an electronic health record, Finland has long been recognised as a pioneer in digital health. The Finnish commitment to digital health is unwavering, with vast datasets, investment in bio banking and genetic research for precision medicine. These technologies are embedding more targeted therapeutics personalised to the individual’s genetic makeup, in turn making treatments more predictive and ultimately helping to deliver better patient outcomes. The Finnish are focussed on the ultimate prize – wellness and prevention rather than a lifetime of reactive treatment.

Traditional care models are reactive, resource intensive and deliver services in high-cost environments. As we enjoy greater life expectancy, we must find alternative approaches to prevent illness and deliver care. Disease prevention and the maintenance of personal wellbeing are among the key shifts in healthcare. Rather than healthcare being ‘provided’ to patients, patients are engaging with health care systems to support them in maintaining health and wellbeing, and where needed, intervening.

Demonstrating the Government’s commitment to more sustainable and equitable models of care, the new digital health strategy points towards more innovation and digitisation to support the virtual care journey. The Irish health service is already embarking on this virtual care journey. Virtual wards can enable patients who might otherwise be in an acute hospital, to be monitored remotely and receive treatment at home. There are multiple virtual care technologies being deployed across health systems. Not only does this allow for improved management of acute illness, but with sensor-based technologies and remote monitoring devices, patients with chronic conditions can be cared for in a way that brings improved quality of life. Digital technology is a key component in this model, and supports the systems vision for a proactive wellness management approach.

Digital investment is not a trivial undertaking and while it may not be the answer to all our health woes, technology, in the right hands, has the ability to profoundly improve every aspect of healthcare, whether in identifying capacity gaps, enhancing productivity, signalling patient risk – or simply directing the patient to alternative care settings. We know that readiness for digital transformation varies across settings and even generations, and for many, some emerging technologies remain elusive at this point. What is central for any healthcare system to thrive or indeed survive however is a ‘whole of health’ approach using the power of digital to remediate many of the immediate challenges including increasing demand, barriers to access, escalating costs and workforce shortages. These global obstacles cannot be overcome through traditional models – digital really does have a role in curing healthcare.

Minister Donnelly recently reinforced the Government’s commitment to ensuring capacity and equity of access, together with significant increases in bed capacity across the new regional healthcare structure. Is this a ‘once in a generation’ opportunity to combine the government’s strategy for digital health with the proposed investment in healthcare infrastructure to achieve a new model of care for Ireland? The answer is “yes”. It’s time to embrace the true potential of innovation, reimagine our healthcare system and unlock a new era of digitally enabled health.

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